Dynamics of below-the-knee arterial blood flow after endovascular revascularisation of peripheral arteries as a potential predictor of clinical outcomes during one-year follow-up

Abstract

Background: Patients with advanced lower limb ischaemia are, at present, mainly treated using revascularisation. Aim: The aim of the study was to investigate whether the dynamics of blood flow in below-the-knee (BTK) arteries assessed by angiography correlate with clinical outcomes after a 12-month follow-up in patients with severe leg ischaemia treated percutaneously. Methods: The current study enrolled 287 consecutive patients who underwent 302 endovascular procedures on the infrainguinal arteries. The mean age of the included participants was 67.4 ± 10.4 years. After the procedure, blood flow in all patent BTK arteries was assessed using frame count (FC). Patients were then evaluated after one, three, six, and 12 months. During the follow-up visits, clinical condition was evaluated based on the Rutherford scale, ankle-brachial index, and the need for reintervention or amputation. Results: Clinical improvement at the end of the follow-up period was observed in 242 (80.1%) cases and no improvement or worsening in was seen in 42 (13.0%) patients. In total, 66 (21.8%) reinterventions and 18 (6%) amputations during the follow-up period were recorded. Patients with higher FC in the tibial anterior artery experienced significantly better clinical improvement within the 12-month follow-up period (p = 0.02). Lower FC predisposed to worse clinical outcomes after angioplasty. Similar tendencies were found for the tibial posterior and fibular arteries but without statistical significance. Conclusions: The results suggest a negative relationship between FC observed on the final angiogram and clinical outcomes in patients undergoing endovascular treatment of the peripheral arteries.

Prognostic Factors for Restenosis of Superficial Femoral Artery after Endovascular Treatment

“…Yamaguchi T et al [26] also found an impact of runoff on the atherosclerotic burden in the femoropopliteal region, observing more ulcerated plaques in patients with poor runoff. Interestingly, Kaczmarczyk et al [27] found a negative correlation between the blood flow velocity and the treatment outcome of endovascular procedures conducted on the infrainguinal arteries. This finding stemmed from the observation that patients with only one patent artery had higher blood flow velocity, whereas in patients with more than one patent artery, the velocity was comparatively lower due to distribution of the blood among patent vessels.…”