Determining End Points for Critical Limb Ischemia Interventions

Cooper, Kyle; Peña, Constantino; Benenati, James F.

doi:10.1053/j.tvir.2016.04.003

Cited by 18 publications

(14 citation statements)

References 34 publications

(31 reference statements)

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“…12 Although increased flow on the angiogram and the presence of wound blush serve as markers for increased perfusion, these parameters remain subjective and are difficult to quantify. [13][14][15] A new technique which can be used to evaluate the results of revascularisation is 2D perfusion angiography (2DPA). This image processing technique creates a 2D colour map and a time density curve (TDC) from the DSA images.…”

Section: Introductionmentioning

confidence: 99%

“…13 These parameters may be used to evaluate the quality of reperfusion and may predict the outcome of a vascular intervention. 13,16 Because 2DPA is a relatively new technique, the number of studies is limited and has mostly focused on the reliability and reproducibility of the colour map and TDC. Studies on the value of 2DPA for the prediction of clinical outcome are scarce.…”

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Clinical validation of 2D perfusion angiography using Syngo iFlow software during peripheral arterial interventions

et al. 2020

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Objective Endovascular surgery is an important treatment modality in peripheral arterial disease. Digital subtraction angiography is the standard post revascularisation diagnostic tool to locate lesions and to evaluate the effect of an intervention. However, interpretation of digital subtraction angiography images is subjective and it is difficult to determine whether revascularisation has been sufficient for clinical improvement. A new technique is 2D perfusion angiography, which creates a 2D colour map and time density curve from the digital subtraction angiography scan for an objective evaluation of the results. However, its clinical relevance is unknown. The aim is to evaluate the association between 2D perfusion angiography parameters and clinical outcome after peripheral arterial interventions. Methods In this retrospective study, post revascularisation angiographic data and clinical data were reviewed of patients who underwent treatment of femoral-popliteal or femoral-tibial arteries. The outcome was assessed at three time points using three classification systems for peripheral arterial disease: Fontaine classification, American Medical Association whole person impairment classification (AMA) and average wound, ischemia, foot infection score. Post revascularisation angiographic data consisted of time density curves of the foot and lower leg which were extracted from the Syngo iFlow system (Siemens Healthineers). For each time density curve, five descriptive parameters were calculated: time of arrival, time to peak, mean transit time, wash-in rate and area under the curve. The association between the time density curve parameters and peripheral arterial disease classification systems was assessed using a regression analysis. Results Between July 2016 and December 2018, 103 patients underwent peripheral endovascular interventions in the hybrid operating room; 39 patients were suitable for analysis, of which 28 patients underwent digital subtraction angiography of the lower leg, 3 patients underwent digital subtraction angiography of the foot and 8 patients underwent digital subtraction angiography of both regions. Limited significant relations were found for time of arrival with Fontainde classification (B = 0.806, p = 0.043) and area under the curve with AMA classification (B = −0.027, p = 0.047). Conclusion In this retrospective study, time density curve parameters (time of arrival and area under the curve), measured in the lower leg, showed a limited significant association with two classification systems for peripheral arterial disease. Future prospective studies to determine the clinical relevance of this 2D perfusion angiography method should focus on standardisation of angiography protocols and comparison of pre- and post-intervention parameters.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Clinical validation of 2D perfusion angiography using Syngo iFlow software during peripheral arterial interventions

et al. 2020

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“…Conclusion -Bovine pericardial patch provides a safe choice in femoral angioplasty with reasonably good patency results and relatively small risk for complications and can be considered comparable to autologous vein patch. Introduction -Current endovascular treatments (EVT) of critical limb ischemia (CLI) have no clear treatment goals 1 . Perfusion Angiography (PA) is an image-processing software based on the change in density per pixel over time, that can help to predict wound healing and clinical success of EVT 2,3 .…”

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confidence: 99%

Perfusion Angiography in the Prediction of Wound Healing in Endovascular Treatment of Critical Limb Ischemia: Translating Imaging Parameters into Clinical Outcomes

Gómez-Jabalera

Alomar

Montoya

et al. 2019

European Journal of Vascular and Endovascular Surgery

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“…In recent years, several authors have performed small translational studies that measured the foot microcirculation function in revascularizated patients with CLI. Microcirculation function was analyzed by means of quantitative imaging test (such as perfusion angiography or indocyanine green angiography) or other betterknown diagnostic tools (such as skin perfusion pressure or transcutaneous oxygen pressure tests) (23)(24)(25). Most of these studies were designed to validate these tests in the clinical setting and their follow-up periods were usually short.…”

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confidence: 99%