Subintimal Recanalization of Femoropopliteal Occlusive Lesions in Patients With Critical Ischemia: 66 Cases

Radiomics of CTA is feasible in identifying muscle ischemia

BACKGROUND

Advanced models based on computed tomography angiography (CTA) radiomics features in discriminating muscle ischemia from normal condition are lacking.

PURPOSE

To investigate the feasibility of radiomics of CTA in discriminating ischemic muscle from normal muscle.

MATERIAL AND METHODS

A total of 102 patients (51 ischemia and 51 non-ischemia) were analyzed using a CTA radiomics method. The radiomics features of muscle were compared between ischemic and normal cases. The maximum relevance minimum redundancy (mRMR) algorithm and least absolute shrinkage and selection operator (LASSO) logistic regression model were used. The receiver operating characteristic (ROC) curve was used to determine the performance of radiomics signature.

RESULTS

Thirty-nine CTA radiomics features were significantly different between the two groups (P < 0.05). By LASSO, six features were used to construct a model. The signature area under the curve was 0.92 and 0.91 in the training and validation cohorts, respectively. The sensitivity and specificity of the signature were 92% and 86% for the training cohort, and 80% and 94% for the validation cohort, respectively.

CONCLUSION

CTA radiomics signature is useful in identifying ischemic muscle in selected patients.

[Revascularisation in patients with failed previous arterial reconstructions]

Redo arterial reconstructions are followed by advanced surgical risk or impossible in some cases. Active introduction of endovascular surgery complements the capabilities of conventional surgical approach. It is presented case report of restoration of patency of synthetic femoral-popliteal shunt with previous occlusion for a long time. The technique of recanalization and stenting of allograft is described. Immediate results are favorable but further research is needed.