title: Patency of runoff detected by MR angiography at 3.0 T with cuff-compression: a predictor of successful endovascular recanalization below the knee.
abstract: OBJECTIVE
  Our aim was to assess the reliability of detecting distal runoff vessels using contrast-enhanced MR angiography (CE-MRA) that were occult on digital subtraction angiography (DSA) for predicting the outcome of endovascular recanalization (ER).
  
  
  METHODS
  This retrospective analysis comprised 63 patients with diabetes (98 limbs) who underwent ER for infrapopliteal lesions. Before ER, they underwent CE-MRA and DSA for peripheral arterial disease; runoff vessels were detected with CE-MRA, but not with DSA. Immediate and follow-up postoperative outcomes were assessed. Univariate analysis was performed to identify variables associated with successful ER.
  
  
  RESULTS
  Successful ER was achieved in 85.7 % of limbs, and runoff score was significantly lower than in failure limbs (5.1 ± 1.1 vs. 6.2 ± 1.3; P < 0.05). During follow-up, sustained ankle-brachial index (ABI) improvement was found in 76.6 % claudication patients, and walking distance improvement in 86.5 %; pain was relieved in 70.6 % of critical limb ischemia (CLI) limbs, ulceration healed in 81.3 %, and limb-salvage rate was 100 %. Restenosis/occlusion rate was higher for patients with CLI at 12 months (48.8 % vs. 96.3 % in claudication; P < 0.01). Runoff score was associated with a significantly higher likelihood of ER success (odds ratio = 4.096, 95 % confidence interval: 2.056-8.158; P < 0.001).
  
  
  CONCLUSIONS
  Runoff vessels detected using CE-MRA could indicate immediate success and better outcome of ER for infrapopliteal occlusions.
  
  
  CONCLUSIONS
  • 3-T MRA with cuff compression displayed distal below-the-knee (BTK) runoffs better than DSA • Detected runoffs indicate high recanalization rate and good clinical outcome • Runoff display provides potential opportunity to perform other backup recanalization strategies.
authors: Department of Diagnostic and Interventional Radiology, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, No. 600, Yi Shan Road, Shanghai, 200233, China.
authors: Yue-Qi
authors: YQ
authors: Zhu
authors: Jun-Gong
authors: JG
authors: Zhao
authors: Jue
authors: J
authors: Wang
authors: Hua-Qiao
authors: HQ
authors: Tan
authors: Hai-Tao
authors: HT
authors: Lu
authors: Fang
authors: F
authors: Liu
authors: Ying-Sheng
authors: YS
authors: Cheng
authors: Li-Ming
authors: LM
authors: Wei
authors: Pei-Lei
authors: PL
authors: Zhang
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015901:Angiography, Digital Subtraction / Q000379:methods; D055109:Ankle Brachial Index; D001157:Arterial Occlusive Diseases / Q000175:diagnosis* / Q000601:surgery; D003287:Contrast Media; D057510:Endovascular Procedures / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D018810:Magnetic Resonance Angiography / Q000379:methods*; D008297:Male; D008875:Middle Aged; D011150:Popliteal Artery; D011237:Predictive Value of Tests; D057234:Preoperative Period; D011379:Prognosis; D015203:Reproducibility of Results; D012189:Retrospective Studies
chemical_list: D003287:Contrast Media