Perfusion Angiography of the Foot in Patients with Critical Limb Ischemia: Description of the Technique

Abstract

The original angiography data can be used to make a time-density curve, which represents the actual perfusion of the foot in time. Angiographic perfusion imaging is a post-processing modality for which no extra contrast or radiation is needed. With this technique, it is possible to get more information about the perfusion status and microcirculation of the foot. This is a step toward functional imaging in CLI patients.

Not All Patients with Critical Limb Ischaemia Require Revascularisation

“…To generate more evidence about the outcomes after conservative therapy, it is suggested that prospective studies such as the BASIL-2 23 (vein bypass first versus endovascular therapy first) also report on the outcome of conservatively treated patients who were not suitable for trial participation. Promising tools for the prediction of outcome after revascularisation and the identification of patients who might not benefit from revascularisation are perfusion angiography 24 and the Wound, Ischaemia, and foot Infection (WIfI) classification system. 25 The WIfI stages were shown to correlate well with clinical outcomes such as major amputation and one year AFS.…”

Characterizing tissue perfusion after lower extremity intervention using two-dimensional color-coded digital subtraction angiography

“…There have been several studies assessing the feasibility of using 2D imaging in detecting changes to perfusion after intervention in the brain [6][7][8] and in the peripheral vasculature. [10][11][12][13][14] This study attempts to validate the 2DP tool in a prospective manner. This study showed that improved flow to distal tissue is reflected by measurable changes in 2DP parameters.…”

“…It has been previously used in analysis of cerebral flow after an intervention [6][7][8][9] and in the peripheral vasculature. [10][11][12][13][14] Here in a prospective study, we sought to determine the feasibility of using the 2DP (Philips Healthcare, Andover, Mass) color-coded angiography to measure hemodynamic changes in the lower extremities after an endovascular intervention in patients with known PAD. We hypothesize that because contrast material would move more slowly down an extremity with severe PAD, two-dimensional (2D) parameters that reflect transit time, such as AT, transit time down the leg, and TTP, would increase, whereas parameters reflecting volume or velocity, such as SI, area under the curve (AUC), and WIR, would decrease.…”

Non-occlusive mesenteric ischemia (NOMI): evaluation of 2D-perfusion angiography (2D-PA) for early treatment response assessment

“…In order to assess the presence of a therapeutic effect, quantify therapy response, and to avoid overtreatment in often severely hypotensive patients, a therapy response analysis tool would be valuable. Nowadays, 2D perfusion angiography (2D-PA) represents an emerging technique for the assessment and quantification of blood flow and tissue perfusion [15,16]. It relies on the dedicated post-processing of standard DSA images and has been used in several organs and for different indications [17][18][19][20].…”