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Functional Imaging of the Foot with Perfusion Angiography in Critical Limb Ischemia

PURPOSE: To report on the first clinical experience with perfusion angiography (PA) of the foot in patients with chronic critical limb ischemia. MATERIALS AND METHODS: PA is a post-processing software algorithm and no extra digital subtraction angiography (DSA) has to be performed for this analysis....

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Autores principales: Reekers, Jim A., Koelemay, Mark J. W., Marquering, Henk A., van Bavel, Ed T.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer US 2015
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4735259/
https://www.ncbi.nlm.nih.gov/pubmed/26627485
http://dx.doi.org/10.1007/s00270-015-1253-6
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author Reekers, Jim A.
Koelemay, Mark J. W.
Marquering, Henk A.
van Bavel, Ed T.
author_facet Reekers, Jim A.
Koelemay, Mark J. W.
Marquering, Henk A.
van Bavel, Ed T.
author_sort Reekers, Jim A.
collection PubMed
description PURPOSE: To report on the first clinical experience with perfusion angiography (PA) of the foot in patients with chronic critical limb ischemia. MATERIALS AND METHODS: PA is a post-processing software algorithm and no extra digital subtraction angiography (DSA) has to be performed for this analysis. The data used to test the feasibility of PA were obtained from a consecutive group of 89 patients with CLI who were treated with standard below the knee angioplasty and 12 separate patients who were not suitable for endovascular revascularization. RESULTS: Motion artifacts in the dataset of the DSA made post-procedural analysis impossible in 10 % intervention. In the majority of patients (59/68) PA showed an increase in volume flow in the foot after successful angioplasty of the crural vessels. However, in 9/68 patients no increase was seen after successful angioplasty. With the use of a local administered competitive α-adrenergic receptor antagonist, it is also possible to test and quantify the capillary resistance index which is a parameter for the remaining functionality of the microcirculation in CLI patients. CONCLUSION: PA might be used as a new endpoint for lower limb revascularization and can also be used to test the functionality the microcirculation to identify sub-types of patients with CLI. Clinical evaluation and standardization of PA is mandatory before introduction in daily practice.
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spelling pubmed-47352592016-02-09 Functional Imaging of the Foot with Perfusion Angiography in Critical Limb Ischemia Reekers, Jim A. Koelemay, Mark J. W. Marquering, Henk A. van Bavel, Ed T. Cardiovasc Intervent Radiol Work In Progress PURPOSE: To report on the first clinical experience with perfusion angiography (PA) of the foot in patients with chronic critical limb ischemia. MATERIALS AND METHODS: PA is a post-processing software algorithm and no extra digital subtraction angiography (DSA) has to be performed for this analysis. The data used to test the feasibility of PA were obtained from a consecutive group of 89 patients with CLI who were treated with standard below the knee angioplasty and 12 separate patients who were not suitable for endovascular revascularization. RESULTS: Motion artifacts in the dataset of the DSA made post-procedural analysis impossible in 10 % intervention. In the majority of patients (59/68) PA showed an increase in volume flow in the foot after successful angioplasty of the crural vessels. However, in 9/68 patients no increase was seen after successful angioplasty. With the use of a local administered competitive α-adrenergic receptor antagonist, it is also possible to test and quantify the capillary resistance index which is a parameter for the remaining functionality of the microcirculation in CLI patients. CONCLUSION: PA might be used as a new endpoint for lower limb revascularization and can also be used to test the functionality the microcirculation to identify sub-types of patients with CLI. Clinical evaluation and standardization of PA is mandatory before introduction in daily practice. Springer US 2015-12-01 2016 /pmc/articles/PMC4735259/ /pubmed/26627485 http://dx.doi.org/10.1007/s00270-015-1253-6 Text en © The Author(s) 2015 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.
spellingShingle Work In Progress
Reekers, Jim A.
Koelemay, Mark J. W.
Marquering, Henk A.
van Bavel, Ed T.
Functional Imaging of the Foot with Perfusion Angiography in Critical Limb Ischemia
title Functional Imaging of the Foot with Perfusion Angiography in Critical Limb Ischemia
title_full Functional Imaging of the Foot with Perfusion Angiography in Critical Limb Ischemia
title_fullStr Functional Imaging of the Foot with Perfusion Angiography in Critical Limb Ischemia
title_full_unstemmed Functional Imaging of the Foot with Perfusion Angiography in Critical Limb Ischemia
title_short Functional Imaging of the Foot with Perfusion Angiography in Critical Limb Ischemia
title_sort functional imaging of the foot with perfusion angiography in critical limb ischemia
topic Work In Progress
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4735259/
https://www.ncbi.nlm.nih.gov/pubmed/26627485
http://dx.doi.org/10.1007/s00270-015-1253-6
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