Objective : The perfusion index (PI) is a physiological marker for evaluating the peripheral circulation. We explored the possibility of using PI as a screening tool for development of critical limb ischemia in peripheral artery disease (PAD). Method : We measured the PI in 79 limbs of 70 PAD patients. Data were analyzed to find a correlation between the PI and PAD severity. Result : The PI tended to be lower as PAD became severer. Especially, there were significant differences between the Fontaine 1 and Fontaine 4 groups in average PI and minimum PI, and between Fontaine 1 and two other groups (Fontaine 2 and Fontaine 4 groups) in maximum PI. A mild correlation was found between PI and the ankle brachial index. These data were used to calculate an average PI of 0.27 as a cut-off value for critical limb ischemia (CLI). In 65 asymptomatic PAD patients and claudication, significantly more patients with a PI value greater than the cut-off value developed CLI than those with a PI lower than the cut-off. Conclusion : The PI can be a useful tool for evaluating the development of CLI in mild PAD patients, and patients tended not to progress to CLI when their average PI was higher than 0.27. (This is a translation of Jpn J Vasc Surg 2020; 29: 103–108.)

whereas medical complications were 2% in SECS and 10% in ABF, including 1 death (p-value¼0.20).The mean follow-up was 27AE21 months. Kaplan-Meyer analysis (fig. 1) showed a primary patency estimate of 94.9% (95% CI, 89-100) and 89.2% (95% CI, 81-99) in SECS and ABF group respectively (p-value¼0.85). Based on a Cox proportional hazard regression analysis, among all preoperative variables only Rutherford Category (HR ¼3.04, P ¼ 0.01) and SVS score (HR¼0.22, P¼0.10) proved to be prognostic factors of primary patency. Similarly, a logistic regression model with dependent variable patency indicated as significant factors only Rutherford Category (P ¼ 0.02) and SVS score (P¼0.05). Conclusion -Endovascular treatment using SECS showed no statistical difference in perioperative and follow-up results as compared to open repair. Rutherford category and SVS score were the only variables able to influence long-term follow-up results.

An adolescent was referred to our hospital with intermittent claudication. The right popliteal artery was extrinsically compressed by the gastrocnemius muscle and was occluded by a thrombus, as shown by computed tomography angiography. The patient was diagnosed with popliteal artery entrapment syndrome. The patient was successfully treated with popliteal artery release and myotomy of the aberrant medial head of the gastrocnemius muscle, thrombectomy, and endarterectomy. In cases where the fibrotic change in the popliteal artery is not severe, whether popliteal artery reconstruction or bypass surgery with musculotendinous sectioning should be performed is controversial.

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