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A New Objective Criterion for Determining, Noninvasively, the Healing Potential of an Ischemic Ulcer

The University of Southern California School of Medicine, Los Angeles County-USC Medical Center and Rancho Los Amigos Hospital, Los Angeles, California

Correspondence: For reprints contact: Michael E. Siegel, MD, LAC-USC Medical Center, Box 693, 1200 N. State St., Los Angeles, CA 90033.

ABSTRACT

Peripheral vascular perfusion studies using intravenously administered thallium-201 were performed on 13 patients suffering from ischemic ulcer of the lower extremities. Scintillation camera views and point counting over the lesion and adjacent region were utilized to define qualitatively and quantitatively the relative hyperemia of the lesion. The preliminary findings demonstrate that when the relative hyperemia was equal to or greater than 1.5, 100% (seven of seven) went on to heal their ulcer with conservative management. Of those without this degree of hyperemia, 83% (five of six) will require amputation. Based on this limited series, noninvasive assessment of the relative hyperemia of an ischemic ulcer using thallium-201 is a new, useful,and objective indicator of the healing potential of a so-called ischemic ulcer.

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