Diagnostic Use of Radioactive Xenon Clearance and a Standardized Walking Test in Obliterative Arterial Disease of the Legs

Abstract

The 133 Xe clearance method was used for studying the muscle blood flow (MBF) and the time course of the hyperemic reaction in the calf muscles during walking. Methodological observations showed that the type of walking markedly influenced the hyperemic reaction. However, even during steady-state walking in trained subjects a variability of 15 to 20% in the muscle blood flow was noted in repeated tests. Clinical studies were made in 11 patients with occlusive arterial disease of the femoral artery and intermittent claudication. Twelve control subjects were also studied. On use of a standardized and fairly strenuous walking test on a treadmill, all 18 legs with intermittent claudication showed abnormal 133 Xe clearance curves from the anterior tibial, the soleus, and the gastrocnemius muscles. All the curves disclosed subnormal MBF during walking and prolonged post-exercise hyperemia. It is concluded that this 133 Xe clearance test constitutes a very direct and diagnostically valuable method for disclosing the basic pathophysiological mechanism underlying intermittent claudication.