| Purpose:Percutaneous Transluminal Angioplasty(PTA)is the first choice for the treatment of Lower Extremity Arteriosclerotic Occlusive Disease(IPAOD).However,as now no mature quantitative imaging evaluation technology was widely applied,we carried out a prospective study utilizing Parametric Color-Coded Digital Subtraction Angiography(iFLow)&Flat-Panel Detector Parenchymal Blood Volume Imaging(FD-PBV)for IPAOD assessment.The aim of this study was to evaluate the effectiveness,safety and the consistency with traditional assessment technology.Methods:DSA series of Below-the-Knee(BTK)area were obtained with a flat-detector angiographic system.Datasets were then derived into parametric color coded 2D-DSA mapping and tissue perfusion quantification utilizing specific workstation,for evaluation of foot blood flow and tissue perfusion,combined with clinical symptoms improvement after operation.Patients'baseline was also monitored throughout PTA treatment,especially renal function(GFR)to safety of contrast medium cost in DSA series images acquisition.for correlation,ABI measurements pre-and post-PTA were recorded for all patients.Results:44 patients were enrolled in the study,with ages of 67.58±9.90.63.64%of whom were men.The main clinical symptoms were rest pain(45.46%(20/44)),diabetes(75%(33/44))was most common comorbidity.After operation,ABI increased from 0.44±0.31 to 0.63±0.26(p<0.0001),TTP(s)decreased significantly from 22.81±7.46 to 14.49±6.03(p<0.0001),HU of foot FD-PBV ROIs increased from 22.81±7.46 to 55.37±29.73(p<0.0001);no renal burden increasement was observed immediately after operation.In subgroup analysis,first we divided all patients into two groups:a group with?ABI?0.15(group A,n=19),a group with ?ABI<0.15(group B,n=25),for ?ABI comparison,group A was 0.40±0.22,group B was 0.40±0.22(p=0.01);for ?TTP(s)comparison,group A was-10.31 ±6.14,group B was-6.80±4.86(p=0.12);for ?HU comparison,group A was 26.37± 14.36,group B was 34.26±28.00(p=0.48).Then we divided all patients into two groups:a group with Diabetes Mellitus(group C,n=33),a group without DM(group D,n=11),for ?ABI comparison,group C was 0.21±0.27,group D was 0.12±0.12(p=0.09);for ?TTP(s)comparison,group C was-7.64±4.99,group D was-10.34±7.21(p=0.07);for ?HU comparison,group C was 27.25±17.83,group D was 41.63±33.64(p=0.31).No renal burden increased after PTA treatment.Pearson Correlation Coefficient test was carried out between ? ABI and ? TTP throughout operation,with a p=-0.22.In subgroup analysis of ?ABI&DM.p(A)=-0.12,p(B)=-0.22,p(C)=-0.25,p(D)=-0.50.During 1 month follow-up,84.09%(3 7/44)patients showed remission,no patients showed aggravation.ABI in one-month follow up was 0.14±0.17;compared to ABI of post-operation immediately,90.91%(40/44)patients achieved improved ABI.90.91%(40/44)patients had decreased ABI,within which only 2.27%(1/44)patient had reduction more than 0.15.no renal burden increasement was observed in one-month follow up.Conclusion:iFLow and FD-PBV are clinically effective and safe for IPAOD evaluation throughout PTA treatment,and proved that diabetes does not affect the improvement of foot perfusion after PTA.Although it shows low consistency with Ankle-Brachial Index,the subgroup analysis indicated that,independent from ABI,iFLow&FD-PBV can provide more accurate details of real-time blood perfusion. |
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