TY - JOUR
TI - 2D perfusion DSA with an open-source, semi-automated, color-coded software for the quantification of foot perfusion following infrapopliteal angioplasty: a feasibility study
AU - Kagadis, G.C.
AU - Tsantis, S.
AU - Gatos, I.
AU - Spiliopoulos, S.
AU - Katsanos, K.
AU - Karnabatidis, D.
JO - European Radiology Experimental
PY - 2020
VL - 4
TODO - 1
SP - null
PB - Springer Science and Business Media Deutschland GmbH
SN - null
TODO - 10.1186/s41747-020-00176-z
TODO - clopidogrel;  contrast medium;  fentanyl;  iodixanol;  lidocaine, adult;  aged;  algorithm;  angiography;  angioplasty;  Article;  artifact;  blood flow;  blood volume;  clinical article;  clinical assessment;  clinical protocol;  clustering algorithm;  computer assisted tomography;  critical limb ischemia;  digital subtraction angiography;  endovascular surgery;  feasibility study;  female;  flow rate;  follow up;  foot perfusion;  human;  image analysis;  image enhancement;  image quality;  image segmentation;  infrapopliteal angioplasty;  intraluminal lesion;  male;  mathematical analysis;  mean transit time;  middle aged;  middle cerebral artery;  percutaneous transluminal angioplasty;  perfusion blood flow;  perfusion blood volume;  popliteal artery;  regions of interest;  revascularization;  signal intensity;  stenosis;  tissue perfusion;  two-dimensional imaging;  vascular access;  wound healing;  blood flow velocity;  computer assisted diagnosis;  diagnostic imaging;  endovascular surgery;  foot;  ischemia;  peripheral occlusive artery disease;  procedures;  prospective study;  software;  vascularization, Algorithms;  Angiography, Digital Subtraction;  Blood Flow Velocity;  Endovascular Procedures;  Feasibility Studies;  Female;  Foot;  Humans;  Ischemia;  Male;  Middle Aged;  Peripheral Arterial Disease;  Prospective Studies;  Radiographic Image Interpretation, Computer-Assisted;  Software
TODO - Background: Foot perfusion has been recently implemented as a new tool for optimizing outcomes of peripheral endovascular procedures. A custom-made, two-dimensional perfusion digital subtraction angiography (PDSA) algorithm has been implemented to quantify outcomes of endovascular treatment of critical limb ischemia (CLI), assist intra-procedural decision-making, and enhance clinical outcomes. Methods: The study was approved by the Hospital’s Ethics Committee. This prospective, single-center study included seven consecutive patients scheduled to undergo infrapopliteal endovascular treatment of CLI. Perfusion blood volume (PBV), mean transit time (MTT), and perfusion blood flow (PBF) maps were extracted by analyzing time-intensity curves and signal intensity on the perfused vessel mask. Mean values calculated from user-specified regions of interest (ROIs) on perfusion maps were employed to evaluate pre- and post-endovascular treatment condition. Measurements were performed immediately after final PDSA. Results: In total, five patients (aged 54 ± 16 years, mean ± standard deviation) were analyzed, as two patients were excluded due to significant motion artifacts. Post-procedural MTT presented a mean decrease of 19.1% for all patients and increased only in 1 of 5 patients, demonstrating in 4/5 patients an increase in tissue perfusion after revascularization. Overall mean PBF and PBV values were also analogously increased following revascularization (446% and 69.5% mean, respectively) and in the majority of selected ROIs (13/15 and 12/15 ROIs, respectively). Conclusions: Quantification of infrapopliteal angioplasty outcomes using this newly proposed, custom-made, intra-procedural PDSA algorithm was performed using PBV, MTT, and PBF maps. Further studies are required to determine its role in peripheral endovascular procedures (ClinicalTrials.gov Identifier: NCT04356092). © 2020, The Author(s).
ER -