PMID- 37288498
OWN - NLM
STAT- Publisher
LR  - 20230608
IS  - 1545-1550 (Electronic)
IS  - 1526-6028 (Linking)
DP  - 2023 Jun 8
TI  - Feasibility and Clinical Value of Intraprocedural Doppler Ultrasonography Blood 
      Flow Parameters During Peripheral Endovascular Procedures for Limb Salvage: A 
      Pilot Study.
PG  - 15266028231179838
LID - 10.1177/15266028231179838 [doi]
AB  - PURPOSE: To investigate whether Doppler ultrasound (DUS) blood flow parameters 
      could serve as quantifiable functional endpoints of peripheral endovascular 
      arterial procedures for chronic limb-threatening ischemia (CLTI), influencing 
      wound healing. METHODS: This is a prospective single-center study investigating 
      intraprocedural DUS parameters (pulsatility index [PI] and pedal acceleration 
      time [PAT]) in quantifying immediate hemodynamic alterations in consecutive CLTI 
      patients with wound, ischemia, and foot infection wound class >/=1 undergoing 
      endovascular interventions. Primary endpoints were feasibility of preendovascular 
      and postendovascular treatment measurements of PI/PAT, quantification of 
      immediate PI/PAT modifications of the posterior and anterior foot circulation 
      following revascularization, the correlation between PI and PAT, and 6-month 
      complete wound healing. Secondary endpoints included the 6-month limb salvage (no 
      major amputation) and complete and partial wound healing rates. RESULTS: A total 
      of 28 patients (75.0% male) were enrolled, and 68 vessels were treated. The 
      overall mean PAT values significantly decreased from 154.15+/-70.35 ms 
      preprocedural to 107.21+/-49.6 ms postprocedural (p<0.01), and the mean PI values 
      significantly increased from 0.93+/-0.99 to 1.92+/-1.96 (p<0.01). Postprocedural PAT 
      at the anterior tibial (r(2)=0.804; p=0.346) and the posterior tibial arteries 
      (r(2)=0.784; p=0.322) had a strong correlation and postprocedural PI at the 
      anterior tibial (r(2)=0.704; p=0.301) and the posterior tibial arteries 
      (r(2)=0.707; p=0.369) had a good correlation with 6-month complete wound healing. 
      The 6-month complete and partial wound healing rates were 38.1% and 47.6%, 
      respectively. Limb salvage was 96.4% and 92.4% at 6 and 12 months of follow-up, 
      respectively. CONCLUSIONS: Pedal acceleration time and PI accurately detected 
      immediate hemodynamic changes of foot perfusion following revascularization and 
      could serve as prognostic factors of wound healing in patients with CLTI. 
      CLINICAL IMPACT: Intraprocedural measurement of simple Doppler ultrasound blood 
      flow parameters, Pulsatility Index (PI) and Pedal Acceleration Time (PAT), 
      accurately detected immediate hemodynamic changes of foot perfusion following 
      endovascular revascularization and could therefore serve as intraprocedural 
      prognostic factors of wound healing in patients with chronic limb-threatening 
      ischemia. This is the first time that PI has been proposed as a hemodynamic index 
      of successful angioplasty outcome. The optimization of intraprocedural PAT and PI 
      could be used to guide angioplasty and predict clinical success.
FAU - Spiliopoulos, Stavros
AU  - Spiliopoulos S
AUID- ORCID: 0000-0003-1860-0568
AD  - Division of Interventional Radiology, 2nd Department of Radiology, "Attikon" 
      University General Hospital, Medical School, National and Kapodistrian University 
      of Athens, Athens, Greece.
FAU - Georgiadou, Magdalini
AU  - Georgiadou M
AUID- ORCID: 0000-0001-6054-6687
AD  - Division of Interventional Radiology, 2nd Department of Radiology, "Attikon" 
      University General Hospital, Medical School, National and Kapodistrian University 
      of Athens, Athens, Greece.
FAU - Karahaliou, Anastasia
AU  - Karahaliou A
AD  - Division of Interventional Radiology, 2nd Department of Radiology, "Attikon" 
      University General Hospital, Medical School, National and Kapodistrian University 
      of Athens, Athens, Greece.
FAU - Grigoriadis, Stavros
AU  - Grigoriadis S
AD  - Division of Interventional Radiology, 2nd Department of Radiology, "Attikon" 
      University General Hospital, Medical School, National and Kapodistrian University 
      of Athens, Athens, Greece.
FAU - Palialexis, Konstantinos
AU  - Palialexis K
AD  - Division of Interventional Radiology, 2nd Department of Radiology, "Attikon" 
      University General Hospital, Medical School, National and Kapodistrian University 
      of Athens, Athens, Greece.
FAU - Reppas, Lazaros
AU  - Reppas L
AD  - Division of Interventional Radiology, 2nd Department of Radiology, "Attikon" 
      University General Hospital, Medical School, National and Kapodistrian University 
      of Athens, Athens, Greece.
FAU - Brountzos, Elias
AU  - Brountzos E
AD  - Division of Interventional Radiology, 2nd Department of Radiology, "Attikon" 
      University General Hospital, Medical School, National and Kapodistrian University 
      of Athens, Athens, Greece.
LA  - eng
PT  - Journal Article
DEP - 20230608
PL  - United States
TA  - J Endovasc Ther
JT  - Journal of endovascular therapy : an official journal of the International 
      Society of Endovascular Specialists
JID - 100896915
SB  - IM
OTO - NOTNLM
OT  - Doppler ultrasound
OT  - chronic limb-threatening ischemia
OT  - endovascular treatment
OT  - pedal acceleration time
OT  - peripheral arterial procedures
OT  - pulsatility index
OT  - wound healing
EDAT- 2023/06/08 06:42
MHDA- 2023/06/08 06:42
CRDT- 2023/06/08 04:38
PHST- 2023/06/08 06:42 [medline]
PHST- 2023/06/08 06:42 [pubmed]
PHST- 2023/06/08 04:38 [entrez]
AID - 10.1177/15266028231179838 [doi]
PST - aheadofprint
SO  - J Endovasc Ther. 2023 Jun 8:15266028231179838. doi: 10.1177/15266028231179838.