The Patency of Tibial/Peroneal Arteries Affects the Increment of Regional Tissue Saturation of Oxygen in Each Angiosome after Superficial Femoral Artery Revascularization

Unno, Naoki; Inuzuka, Kazunori; Yamamoto, Naoto; Sano, Masaki; Katahashi, Kazuto; Kayama, Takafumi; Yata, Tatsuro; Yamanaka, Yutaka; Tsuyuki, Hajime; Endo, Yusuke; Ishikawa, Nozomu; Naruse, Ena; Niwayama, Masatsugu; Takeuchi, Hiroya

doi:10.3400/avd.oa.21-00097

Cited by 1 publication

(1 citation statement)

References 29 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In a recent study, Unno et al 18 employed a near-infrared spectroscopy oximeter (TOE-20) for real-time monitoring of regional tissue oxygen saturation (rSO2) in the foot angiosomes of 23 CLTI patients who underwent recanalization of the superficial femoral artery. In their study, rSO2 increased in all angiosomes after revascularization, and the increase was larger if the crural artery feeding the angiosome was patent when compared to the angiosomes with an occlusion in the feeding crural artery.…”

Section: Discussionmentioning

confidence: 99%

Perfusion increase in foot angiosomes: Comparison between direct and indirect revascularization of crural arteries

Venermo,

Settembre

2024

Scand J Surg

View full text Add to dashboard Cite

Background and aims: In retrospective studies, wound healing and leg salvage have been better if revascularization is targeted to the crural artery supplying arterial flow to the wound angiosome. No data exist on how revascularization changes the blood flow in foot angiosomes. The aim of this study was to evaluate the change in perfusion after infrapopliteal artery revascularization in all foot angiosomes and to compare directly revascularized (DR) angiosomes to the indirectly revascularized (IR) angiosomes. Methods: In this prospective study, foot perfusion was measured with indocyanine green fluorescence imaging (ICG-FI) before and after either surgical or endovascular below-knee revascularization. According to angiograms, we divided the foot angiosomes into DR and IR angiosomes. Furthermore, in a subanalysis, the IR angiosomes were graded as IR_Coll+ angiosomes if there were strong collaterals arising from the artery which was revascularized, and as IR_Coll– angiosomes if strong collaterals were not seen. Results: A total of 72 feet (28 bypass, 44 endovascular revascularizations) and 282 angiosomes were analyzed. Surgical and endovascular revascularization increased perfusion significantly in both DR and IR angiosomes. After bypass surgery, the increase in DR angiosomes was 55 U and 53 U in IR angiosomes; there were no significant difference in the perfusion increase between IR and DR angiosomes. After endovascular revascularization, perfusion increased significantly more, 40 U, in DR angiosomes compared to 26 U in IR angiosomes (p < 0.05). In the subanalysis of IR angiosomes, perfusion increased significantly after surgical bypass regardless of whether strong collaterals were present or not. After endovascular revascularization, however, a significant perfusion increase was noted in the IR_Coll+ but not in the IR_Coll− subgroup. Conclusion: Open revascularization increased perfusion equally in DR and IR angiosomes, whereas endovascular revascularization increased perfusion significantly more in DR than in IR angiosomes. Strong collateral network may help increase perfusion in IR angiosomes.

show abstract

Section: Discussionmentioning

confidence: 99%