title: Functional Imaging of the Foot with Perfusion Angiography in Critical Limb Ischemia.
abstract: OBJECTIVE
  To report on the first clinical experience with perfusion angiography (PA) of the foot in patients with chronic critical limb ischemia.
  
  
  METHODS
  PA is a post-processing software algorithm and no extra digital subtraction angiography (DSA) has to be performed for this analysis. The data used to test the feasibility of PA were obtained from a consecutive group of 89 patients with CLI who were treated with standard below the knee angioplasty and 12 separate patients who were not suitable for endovascular revascularization.
  
  
  RESULTS
  Motion artifacts in the dataset of the DSA made post-procedural analysis impossible in 10 % intervention. In the majority of patients (59/68) PA showed an increase in volume flow in the foot after successful angioplasty of the crural vessels. However, in 9/68 patients no increase was seen after successful angioplasty. With the use of a local administered competitive α-adrenergic receptor antagonist, it is also possible to test and quantify the capillary resistance index which is a parameter for the remaining functionality of the microcirculation in CLI patients.
  
  
  CONCLUSIONS
  PA might be used as a new endpoint for lower limb revascularization and can also be used to test the functionality the microcirculation to identify sub-types of patients with CLI. Clinical evaluation and standardization of PA is mandatory before introduction in daily practice.
authors.affiliation: Dept of Radiology, AMC, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands. j.a.reekers@amc.uva.nl.|Department of Radiology G1.206, Academic Medical Center, University of Amsterdam, Meibergdreef 9, PO box 22660, 1100 DD, Amsterdam, The Netherlands. j.a.reekers@amc.uva.nl.
authors.forename: Jim A
authors.initials: JA
authors.lastname: Reekers
authors.affiliation: Dept of Vascular Surgery, AMC, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands. m.j.koelemaij@amc.uva.nl.
authors.forename: Mark J W
authors.initials: MJ
authors.lastname: Koelemay
authors.affiliation: Dept of Biomedical Engineering and Physics, AMC, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands. h.a.marquering@amc.uva.nl.
authors.forename: Henk A
authors.initials: HA
authors.lastname: Marquering
authors.affiliation: Dept of Biomedical Engineering and Physics, AMC, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands. e.vanbavel@amc.uva.n.
authors.forename: Ed T
authors.initials: ET
authors.lastname: van Bavel
mesh_terms: D000465:Algorithms; D015901:Angiography, Digital Subtraction / Q000379:methods*; D017130:Angioplasty; D016477:Artifacts; D003287:Contrast Media; D005240:Feasibility Studies; D005260:Female; D005528:Foot / Q000098:blood supply*; D006801:Humans; D007511:Ischemia / Q000000981:diagnostic imaging* / Q000628:therapy; D008297:Male; D011446:Prospective Studies; D011857:Radiographic Image Interpretation, Computer-Assisted; D014283:Triiodobenzoic Acids; D014655:Vascular Resistance
chemical_list: D003287:Contrast Media; D014283:Triiodobenzoic Acids; C044834:iodixanol
keywords: Arterial intervention; Arteriosclerosis; Clinical practice; Diabetes; Diagnostic; Experimental IR; Imaging; Ischemia