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Impaired pedal arch affects the treatment effect in patients with single tibial artery revascularization demonstrated by intraoperative perfusion

Authors
  • Shao, Jiang
  • Ma, Jiangyu
  • Lai, Zhichao
  • Yu, Xiaoxi
  • Li, Kang
  • Xu, Leyin
  • Chen, Junye
  • Wang, Chaonan
  • Cao, Wenteng
  • Liu, Xiaolong
  • Yuan, Jinghui
  • Liu, Bao
Type
Published Article
Journal
Quantitative Imaging in Medicine and Surgery
Publisher
AME Publishing Company
Publication Date
Jun 01, 2022
Volume
12
Issue
6
Pages
3204–3212
Identifiers
DOI: 10.21037/qims-21-801
PMID: 35655837
PMCID: PMC9131341
Source
PubMed Central
Keywords
Disciplines
  • Original Article
License
Unknown

Abstract

Background The treatment strategy for patients with multiple infrapopliteal artery occlusions remains controversial. In this study, we investigated how anatomic factors affect the treatment effect of infrapopliteal artery intervention and identified suitable intervention strategies for patients with multiple infrapopliteal artery occlusions. Methods This was a prospective, single-center, observational cohort study. For each patient, the intrainterventional blood volume improvement of the dorsum and plantar surface was measured and classified into the direct perfused region (DR) or indirect perfused region (IR) on the basis of whether the supplying artery was revascularized. Digital subtraction angiography was performed to analyze how pedal arch patency affects blood communication between DR and IR. Results A total of 38 patients treated with infrapopliteal intervention at the Department of Vascular Surgery of Peking Union Medical College Hospital from November 2016 to November 2020 were considered for inclusion in this study. Finally, 26 patients were included in the analysis. In patients with type III pedal arch, blood volume improvements for DR and IR were 70.50 (17.50, 191.75) and 11.25 (−10.25, 50.25) mL/1,000 mL, respectively (P=0.018). No significant difference was found between DR and IR in patients with type I pedal arch (P=0.208) and type II pedal arch (P=0.110). Conclusions Impaired pedal arch has an adverse impact on foot collateral circulation. Patients with these conditions are more suitable for direct revascularization than other patients. Trial Registration ClinicalTrials.gov identifier: NCT03248323.

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