Significance of Distal Runoff Score as a Key Influencer on Clinical Outcomes after Endovascular Interventions for Superficial Femoral Artery Disease

El-Sharkawi, Mohamed E.; Elsherif, Mohamed; Ghoneim, Baker; O’Sullivan, Miriam; McCormack, Emilie; Tawfick, Wael; Sultan, Sherif

doi:10.1016/j.avsg.2020.11.024

Cited by 8 publications

(5 citation statements)

References 21 publications

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“…It was reported that some of the risk factors for acute thrombotic occlusion (ATO) after EVT were the lesion involving the popliteal artery and poor runoff. 5 , 6 These were observed in this case. Therefore, this case was at risk of ATO after EVT regardless of EXOSEAL use.…”

Section: Discussionsupporting

confidence: 72%

Intravascular ultrasound findings of the protrusion of the EXOSEAL plug that caused acute limb ischemia

Suzuki

Dannoura²,

Asakawa³

et al. 2023

Journal of Vascular Surgery Cases, Innovations and Techniques

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Section: Discussionsupporting

confidence: 72%

Intravascular ultrasound findings of the protrusion of the EXOSEAL plug that caused acute limb ischemia

Suzuki

Dannoura²,

Asakawa³

et al. 2023

Journal of Vascular Surgery Cases, Innovations and Techniques

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“…Based on the results of previous studies ( 5 , 9 , 16 , 18 , 19 ) and physician experience, we assume patency rates of 80 and 65%, 75 and 60%, and 50 and 30% in the intervention and non-intervention groups, respectively, in the good, compromised and poor tibial runoff group. Assuming 1-sided α = 0.025 and β = 80%, at least 432, 365 and 200 subjects are required for the good, compromised and poor tibial runoff group, respectively, to account for a potential 20% attrition rate.…”

Section: Methods and Analysismentioning

confidence: 99%

A prospective, multicenter, real-world observational study evaluating the impact of tibial runoff on clinical outcomes after endovascular therapy for femoropopliteal lesions: Research protocol

Liu

Wang

et al. 2022

Front. Cardiovasc. Med.

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IntroductionCurrent evidence indicates endovascular intervention is a safe and effective treatment for peripheral artery disease of the lower extremity. However, the clinical outcome of endovascular intervention for femoropopliteal lesions has been shown to be affected by the status of tibial runoff. It remains unclear whether endovascular intervention for tibial runoff is associated with additional benefits.Methods and analysisThis prospective, multicenter, real-world observational study is carried out from January 2021 to December 2022 in 8 designated centers across China with an estimated sample size of 1200 patients with severe femoropopliteal disease. The pre-procedural status of tibial runoff is evaluated with the modified SVS score and categorized as good (SVS <5), compromised (SVS 5–10) or poor (SVS >10). Whether the patient will be treated with endovascular intervention for tibial runoff is determined by the treating vascular surgeons. Patients are dichotomized into the intervention group and the non-intervention group, with each group further divided into the good, compromised and poor tibial run-off subgroup, yielding 6 subgroups in total. Patients within various subgroups are compared with regard to the primary patency rate of the femoropopliteal artery, changes in quality of life, changes of Rutherford category, improvement of the Wound, Ischemia, and Foot Infection Classification, and incidence of major adverse events over 24-months follow-up. The results of this study may provide important information to help vascular sspecialists to decide whether the tibial runoff should be endovascularly intervened and which patient population benefits most from tibial runoff intervention.Clinical trial registrationhttps://clinicaltrials.gov/ct2/show/NCT04675632?id=NCT04675632&draw=2&rank=1, NCT04675632.

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“…The severity and extent of PAD were evaluated using the modified Society for Vascular Surgery runoff score based on DSA and CTA, respectively [5,6]. The runoff score ranged from 0 to 19, with a higher score indicating more severe disease, and was calculated by assessing the patency and degree of stenosis/occlusion in the lower leg artery segments [22][23][24]. According to the DSA results, the enrolled patients were divided into two groups: mild PAD (DSA score ≤ 7) and severe PAD (DSA score > 7) [25,26].…”

Section: Image Evaluationmentioning

confidence: 99%

Association of lower extremity peripheral arterial disease with quantitative muscle features from computed tomography angiography

Hu,

Chen,

et al. 2024

Insights Imaging

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Objectives To explore the association between lower extremity muscle features from CTA and peripheral arterial disease (PAD) severity using digital subtraction angiography (DSA) as reference standard. Methods Informed consent was waived for this Institutional Review Board approved retrospective study. PAD patients were recruited from July 2016 to September 2020. Two radiologists evaluated PAD severity on DSA and CTA using runoff score. The patients were divided into two groups: mild PAD (DSA score ≤ 7) vs. severe PAD (DSA score > 7). After segmenting lower extremity muscles from CTA, 95 features were extracted for univariable analysis, logistic regression model (LRM) analysis, and sub-dataset analysis (PAD prediction based on only part of the images). AUC of CTA score and LRMs for PAD prediction were calculated. Features were analyzed using Student’s t test and chi-squared test. p < 0.05 was considered statistically significant. Results A total of 56 patients (69 ± 11 years; 38 men) with 56 lower legs were enrolled in this study. The lower leg muscles of mild PAD group (36 patients) showed higher CT values (44.6 vs. 39.5, p < 0.001) with smaller dispersion (35.6 vs. 41.0, p < 0.001) than the severe group (20 patients). The AUC of CTA score, LRM-I (constructed with muscle features), and LRM-II (constructed with muscle features and CTA score) for PAD severity prediction were 0.81, 0.84, and 0.89, respectively. The highest predictive performance was observed in the image subset of the middle and inferior segments of lower extremity (LRM-I, 0.83; LRM-II, 0.90). Conclusions Lower extremity muscle features are associated with PAD severity and can be used for PAD prediction. Critical relevance statement Quantitative image features of lower extremity muscles are associated with the degree of lower leg arterial stenosis/occlusion and can be a beneficial supplement to the current imaging methods of vascular stenosis evaluation for the prediction of peripheral arterial disease severity. Key points • Compared with severe PAD, lower leg muscles of mild PAD showed higher CT values (39.5 vs. 44.6, p < 0.001). • Models developed with muscle CT features had AUC = 0.89 for predicting PAD. • PAD severity prediction can be realized through the middle and inferior segment of images (AUC = 0.90). Graphical Abstract

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Significance of Distal Runoff Score as a Key Influencer on Clinical Outcomes after Endovascular Interventions for Superficial Femoral Artery Disease

Cited by 8 publications

References 21 publications

Intravascular ultrasound findings of the protrusion of the EXOSEAL plug that caused acute limb ischemia

Intravascular ultrasound findings of the protrusion of the EXOSEAL plug that caused acute limb ischemia

A prospective, multicenter, real-world observational study evaluating the impact of tibial runoff on clinical outcomes after endovascular therapy for femoropopliteal lesions: Research protocol

Association of lower extremity peripheral arterial disease with quantitative muscle features from computed tomography angiography

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