title: Evaluation of a novel 2D perfusion angiography technique independent of pump injections for assessment of interventional treatment of peripheral vascular disease.
abstract: To evaluate a novel 2D-perfusion angiography (2D-PA) technique allowing pro- and retrospective flow analysis based on a proximal reference region of interest (ROI) and distal target ROI in patients treated for peripheral arterial disease. 2D-PA allows quantifying blood flow by post-processing of digital subtraction angiography (DSA). 2D-PA was performed pre and post interventional treatment of peripheral arterial disease (PAD; n = 24; 13 angioplasties, 11 stents) in 21 patients (17 men, 72 ± 9y) with Fontaine stage IIB / III. Time-to-peak (TTP), peak density (PD) and area-under-the-curve (AUC) were calculated. Ratios reference/target ROI (TTPOUTFLOW/TTPINFLOW; PDOUTFLOW/PDINFLOW; AUCOUTFLOW/AUCINFLOW) were calculated and correlated to changes in the ankle-brachial-index (ABI). 2D-PA was technically feasible in all cases. A significant increase in ABI was seen after interventional treatment (+39%; p < 0.0001). ABI increase was accompanied by an increase of 36% of PDOUTFLOW/PDINFLOW(p < 0.0001), a 52% decrease of TTPOUTFLOW/TTPINFLOW(p = 0.0007) and a 69% increase of AUCOUTFLOW/AUCINFLOW(p < 0.0001). The difference of TTP pre- and post-intervention showed a correlation with the difference in ABI (r = -0.53, p = 0.0081). The other measured parameters failed to demonstrate significant correlation with improved ABI. The presented 2D-PA technique allows quantitative assessment of arterial flow before, during and after interventional treatment in PAD.
authors: Department of Diagnostic and Interventional Radiology, Hannover Medical School, Carl-Neuberg-Str. 1, 30625, Hanover, Germany. hinrichs.jan@mh-hannover.de.
authors: Jan B
authors: JB
authors: Hinrichs
authors: Department of Diagnostic and Interventional Radiology, Beaumont Hospital, Dublin, Ireland.
authors: Tim
authors: T
authors: Murray
authors: Department of Cardiology and Angiology, Hannover Medical School, Hanover, Germany.
authors: Muharrem
authors: M
authors: Akin
authors: Department of Diagnostic and Interventional Radiology, Beaumont Hospital, Dublin, Ireland.
authors: Michael
authors: M
authors: Lee
authors: Department of Cardiology and Angiology, Hannover Medical School, Hanover, Germany.
authors: Micheal Ulrich
authors: MU
authors: Brehm
authors: Department of Cardiothoracic, Transplantation and Vascular Surgery, Hannover Medical School, Hanover, Germany.
authors: Mathias
authors: M
authors: Wilhelmi
authors: Department of Diagnostic and Interventional Radiology, Hannover Medical School, Carl-Neuberg-Str. 1, 30625, Hanover, Germany.
authors: Frank K
authors: FK
authors: Wacker
authors: Department of Diagnostic and Interventional Radiology, Hannover Medical School, Carl-Neuberg-Str. 1, 30625, Hanover, Germany.
authors: Thomas
authors: T
authors: Rodt
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D015901:Angiography, Digital Subtraction / Q000379:methods*; D017130:Angioplasty / Q000009:adverse effects / Q000295:instrumentation; D055109:Ankle Brachial Index; D001783:Blood Flow Velocity; D005260:Female; D006801:Humans; D035002:Lower Extremity / Q000098:blood supply*; D008297:Male; D008875:Middle Aged; D055420:Perfusion Imaging / Q000379:methods*; D058729:Peripheral Arterial Disease / Q000000981:diagnostic imaging* / Q000503:physiopathology / Q000628:therapy*; D011237:Predictive Value of Tests; D011857:Radiographic Image Interpretation, Computer-Assisted; D015641:Radiography, Interventional; D012039:Regional Blood Flow; D015203:Reproducibility of Results; D012189:Retrospective Studies; D015607:Stents; D013997:Time Factors; D016896:Treatment Outcome
keywords: 2D-Perfusion angiography; Endovascular treatment; Percutaneous angioplasty; Peripheral arterial disease; Stent