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Wang LY, Hu SL, Yao ZF, Xue M, Lu ZQ, Xiao-ju Z, Ding Y. Correlation between cancer-related cognitive impairment and resting cerebral glucose metabolism in patients with ovarian cancer. Heliyon 2024; 10:e34106. [PMID: 39113970 PMCID: PMC11305194 DOI: 10.1016/j.heliyon.2024.e34106] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2023] [Revised: 07/02/2024] [Accepted: 07/03/2024] [Indexed: 08/10/2024] Open
Abstract
Background An increasing number of research have applied neuroimaging techniques to explore the potential neurobiological mechanism of Cancer-related cognitive impairment (CRCI). Purpose To explore the correlation between resting brain glucose metabolism and CRCI using 18F-FDG PET/CT in ovarian cancer (OC) patients. Methods From December 2021 to March 2022, 38 patients with OC were selected as the study group, and 38 healthy women of the same age (±1 year) who underwent routine physical examination using PET/CT were selected as the control group. Patients received further assessment with the Montreal Cognitive Assessment Scale (MoCA) and Perceived Deficit Questionnaire (PDQ). Independent sample t-test and Spearman correlation were conducted for data analysis. Results The resting brain glucose metabolism in the OC group was significantly lower than in the healthy controls. 60.52 % patients had neuropsychological impairment and retrospective memory were the most serious perceived cognitive impairments. The resting brain glucose metabolism in OC patients did not significantly correlate with neuropsychological performance but had significant positive correlation with subjective cognitive evaluation. Discussion Resting glucose metabolism was low in OC patients and associated with subjective cognitive impairment but not objective neuropsychological test results. 18F-FDG PET/CT can be used to evaluate brain function in OC patients and provide reliable imaging indicators for early recognition of and intervention for changes in cognitive function.
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Affiliation(s)
- Li-ying Wang
- Department of Nursing, Fudan University Shanghai Cancer Center, Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, 200032, China
- School of Nursing, Fudan University, Shanghai, 200032, China
| | - Si-long Hu
- Department of Nuclear Medicine, Shanghai Cancer Center, Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, 200032, China
| | - Zhi-feng Yao
- Department of Nuclear Medicine, Shanghai Cancer Center, Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, 200032, China
| | - Mei Xue
- Department of Nursing, Fudan University Shanghai Cancer Center, Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, 200032, China
| | - Zhen-qi Lu
- Department of Nursing, Fudan University Shanghai Cancer Center, Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, 200032, China
| | - Zhang Xiao-ju
- Department of Nursing, Fudan University Shanghai Cancer Center, Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, 200032, China
| | - Yan Ding
- Department of Nursing, Obstetrics & Gynecology Hospital of Fudan University, Shanghai, 200090, China
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Yu J, Hua L, Cao X, Chen Q, Zeng X, Yuan Z, Wang Y. Construction of an individualized brain metabolic network in patients with advanced non-small cell lung cancer by the Kullback-Leibler divergence-based similarity method: A study based on 18F-fluorodeoxyglucose positron emission tomography. Front Oncol 2023; 13:1098748. [PMID: 36969017 PMCID: PMC10036828 DOI: 10.3389/fonc.2023.1098748] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2022] [Accepted: 02/13/2023] [Indexed: 03/12/2023] Open
Abstract
BackgroundLung cancer has one of the highest mortality rates of all cancers, and non-small cell lung cancer (NSCLC) accounts for the vast majority (about 85%) of lung cancers. Psychological and cognitive abnormalities are common in cancer patients, and cancer information can affect brain function and structure through various pathways. To observe abnormal brain function in NSCLC patients, the main purpose of this study was to construct an individualized metabolic brain network of patients with advanced NSCLC using the Kullback-Leibler divergence-based similarity (KLS) method.MethodsThis study included 78 patients with pathologically proven advanced NSCLC and 60 healthy individuals, brain 18F-FDG PET images of these individuals were collected and all patients with advanced NSCLC were followed up (>1 year) to confirm their overall survival. FDG-PET images were subjected to individual KLS metabolic network construction and Graph theoretical analysis. According to the analysis results, a predictive model was constructed by machine learning to predict the overall survival of NSLCL patients, and the correlation with the real survival was calculated.ResultsSignificant differences in the degree and betweenness distributions of brain network nodes between the NSCLC and control groups (p<0.05) were found. Compared to the normal group, patients with advanced NSCLC showed abnormal brain network connections and nodes in the temporal lobe, frontal lobe, and limbic system. The prediction model constructed using the abnormal brain network as a feature predicted the overall survival time and the actual survival time fitting with statistical significance (r=0.42, p=0.012).ConclusionsAn individualized brain metabolic network of patients with NSCLC was constructed using the KLS method, thereby providing more clinical information to guide further clinical treatment.
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Affiliation(s)
- Jie Yu
- Department of Nuclear Medicine, The Fifth Affiliated Hospital of Sun Yat-sen University, Sun Yat-sen University, Zhuhai, Guangdong, China
| | - Lin Hua
- Faculty of Health Sciences, University of Macau, Macau, Macau SAR, China
- Centre for Cognitive and Brain Sciences, University of Macau, Macau, Macau SAR, China
| | - Xiaoling Cao
- Department of Nuclear Medicine, The Fifth Affiliated Hospital of Sun Yat-sen University, Sun Yat-sen University, Zhuhai, Guangdong, China
| | - Qingling Chen
- Department of Nuclear Medicine, The Fifth Affiliated Hospital of Sun Yat-sen University, Sun Yat-sen University, Zhuhai, Guangdong, China
| | - Xinglin Zeng
- Faculty of Health Sciences, University of Macau, Macau, Macau SAR, China
| | - Zhen Yuan
- Faculty of Health Sciences, University of Macau, Macau, Macau SAR, China
- Centre for Cognitive and Brain Sciences, University of Macau, Macau, Macau SAR, China
- *Correspondence: Zhen Yuan, ; Ying Wang,
| | - Ying Wang
- Department of Nuclear Medicine, The Fifth Affiliated Hospital of Sun Yat-sen University, Sun Yat-sen University, Zhuhai, Guangdong, China
- *Correspondence: Zhen Yuan, ; Ying Wang,
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Kang B, Zhao C, Ma J, Wang H, Gu X, Xu H, Zhong S, Gao C, Xu X, A X, Xie J, Du M, Shen J, Xiao L. Electroacupuncture alleviates pain after total knee arthroplasty through regulating neuroplasticity: A resting-state functional magnetic resonance imaging study. Brain Behav 2023; 13:e2913. [PMID: 36749304 PMCID: PMC10013951 DOI: 10.1002/brb3.2913] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/13/2022] [Revised: 01/10/2023] [Accepted: 01/15/2023] [Indexed: 02/08/2023] Open
Abstract
INTRODUCTION We aimed to evaluate the efficacy of electroacupuncture in relieving acute pain after total knee arthroplasty (TKA) and related mechanism. METHODS In this randomized, single-blind, and sham-acupuncture controlled study. Forty patients with postoperative acute pain were recruited and randomly divided electroacupuncture group (n = 20) and sham-acupuncture group (n = 20) from November 2020 to October 2021. All patients received electroacupuncture or sham-acupuncture for 5 days after TKA. Their brain regions were scanned with resting-state functional magnetic resonance imaging before and after intervention. Pain was scaled. Another 40 matched healthy controls underwent scanning once. The amplitude of low-frequency fluctuation (ALFF) values was compared. Pearson's correlation analysis was utilized to explore the correlation of ALFF with clinical variables in patients after intervention. RESULTS Compared with the HCs, patients with acute pain following TKA had significantly decreased ALFF value in right middle frontal gyrus, right supplementary motor area, bilateral precuneus, right calcarine fissure and surrounding cortex, and left triangular part of inferior frontal gyrus (false discovery rate corrected p < .05). Patients had higher ALFF value in bilateral precuneus, right cuneus, right angular gyrus, bilateral middle occipital gyrus, and left middle temporal gyrus after electroacupuncture (AlphaSim corrected p < .01). Correlation analysis revealed that the change (postoperative day 7 to postoperative day 3) of ALFF in bilateral precuneus were negatively correlated with the change of NRS scores (r = -0.706; p = .002; 95% CI = -0.890 to -0.323) in EA group. CONCLUSIONS The functional activities of related brain regions decreased in patients with acute pain after TKA. The enhancement of the functional activity of precuneus may be the neurobiological mechanism of electroacupuncture in treating pain following TKA.
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Affiliation(s)
- Bingxin Kang
- Department of Rehabilitation centersThe First Affiliated Hospital of Henan University of Chinese MedicineZhengzhouChina
| | - Chi Zhao
- Acupuncture Tuina InstituteHenan University of Chinese MedicineZhengzhouChina
| | - Jie Ma
- Center of Rehabilitation MedicineYueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese MedicineShanghaiChina
| | - Haiqi Wang
- Department of OrthopaedicsShanghai Guanghua Hospital of Integrative Chinese and Western MedicineShanghaiChina
| | - Xiaoli Gu
- Department of OrthopaedicsShanghai Guanghua Hospital of Integrative Chinese and Western MedicineShanghaiChina
| | - Hui Xu
- Acupuncture Tuina InstituteHenan University of Chinese MedicineZhengzhouChina
| | - Sheng Zhong
- Department of OrthopaedicsShanghai Guanghua Hospital of Integrative Chinese and Western MedicineShanghaiChina
| | - Chenxin Gao
- Department of OrthopaedicsShanghai Guanghua Hospital of Integrative Chinese and Western MedicineShanghaiChina
| | - Xirui Xu
- Department of OrthopaedicsShanghai Guanghua Hospital of Integrative Chinese and Western MedicineShanghaiChina
| | - Xinyu A
- Department of OrthopaedicsShanghai Guanghua Hospital of Integrative Chinese and Western MedicineShanghaiChina
| | - Jun Xie
- Department of OrthopaedicsShanghai Guanghua Hospital of Integrative Chinese and Western MedicineShanghaiChina
| | - Mengmeng Du
- Department of Rehabilitation centersThe First Affiliated Hospital of Henan University of Chinese MedicineZhengzhouChina
- Depart of Peripheral vascularThe First Affiliated Hospital of Henan University of Chinese MedicineZhengzhouChina
| | - Jun Shen
- Department of OrthopaedicsShanghai Guanghua Hospital of Integrative Chinese and Western MedicineShanghaiChina
- Arthritis Institute of Integrated Traditional Chinese and Western MedicineShanghai University of Traditional Chinese MedicineShanghaiChina
| | - Lianbo Xiao
- Department of OrthopaedicsShanghai Guanghua Hospital of Integrative Chinese and Western MedicineShanghaiChina
- Arthritis Institute of Integrated Traditional Chinese and Western MedicineShanghai University of Traditional Chinese MedicineShanghaiChina
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Li W, Bi Z, Wu J, Duan X, Pang L, Jing Y, Yin X, Cheng H. Effect of depression disorder on the efficacy and quality of life of first-line chemotherapy combined with immunotherapy in oncogene-driver negative NSCLC patients. Front Oncol 2022; 12:772102. [PMID: 35957880 PMCID: PMC9359314 DOI: 10.3389/fonc.2022.772102] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2021] [Accepted: 06/30/2022] [Indexed: 11/21/2022] Open
Abstract
Objective The current research was to assess the relevance between depression disorder and first-line chemotherapy combined with immunotherapy, quality of life in patients with oncogene-driver negative non-small cell cancer (NSCLC). Methods NSCLC patients (33 with depression disorder and 34 with no depression disorder) who was received first-line chemotherapy combined with immunotherapy performed Zung Self-rating Depression Scale (SDS) and European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ-C30). Results The Progression-Free Survival (PFS) of depression disorder group survivors were lower than these of no depression disorder group survivors (HR, 0.352; 95% CI, 0.201-0.617; P<0.05). The statistical significant was revealed about the Objective Response Rate (ORR) and Disease Control Rate (DCR) in two groups (P<0.05). The quality of life scores of NSCLC patients in no depression disorder group was significantly higher after chemotherapy combined with immunotherapy, and manifested as 92.7 ± 28 vs. 76.3 ± 23.3 (t=8.317, P<0.05), and had a significant difference. Conclusion Depression disorder in oncogene-driver negative NSCLC patients influence the curative effect of chemotherapy combined with immunotherapy, and depression disorder was significantly negatively associated with quality of life following chemotherapy combined with immunotherapy.
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Affiliation(s)
- Wen Li
- Cancer Treatment Center, The Second Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Ziran Bi
- Cancer Treatment Center, The Second Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Junxu Wu
- Department of Cardiothoracic Surgery, The Second Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Xu Duan
- Cancer Treatment Center, The Second Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Lulian Pang
- Cancer Treatment Center, The Second Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Yanyan Jing
- Cancer Treatment Center, The Second Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Xiangxiang Yin
- Cancer Treatment Center, The Second Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Huaidong Cheng
- Cancer Treatment Center, The Second Affiliated Hospital of Anhui Medical University, Hefei, China
- *Correspondence: Huaidong Cheng,
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Liu S, Yin N, Li C, Li X, Ni J, Pan X, Ma R, Wu J, Feng J, Shen B. Topological Abnormalities of Pallido-Thalamo-Cortical Circuit in Functional Brain Network of Patients With Nonchemotherapy With Non-small Cell Lung Cancer. Front Neurol 2022; 13:821470. [PMID: 35211086 PMCID: PMC8860807 DOI: 10.3389/fneur.2022.821470] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2021] [Accepted: 01/07/2022] [Indexed: 12/11/2022] Open
Abstract
INTRODUCTION Some previous studies in patients with lung cancer have mainly focused on exploring the cognitive dysfunction and deficits of brain function associated with chemotherapy. However, little is known about functional brain alterations that might occur prior to chemotherapy. Therefore, this study aimed to evaluate brain functional changes in patients with nonchemotherapy before chemotherapy with non-small cell lung cancer (NSCLC). METHODS Resting-state functional MRI data of 35 patients with NSCLC and 46 matched healthy controls (HCs) were acquired to construct functional brain networks. Graph theoretical analysis was then applied to investigate the differences of the network and nodal measures between groups. Finally, the receiver operating characteristic (ROC) curve analysis was performed to distinguish between NSCLC and HC. RESULTS Decreased nodal strength was found in the left inferior frontal gyrus (opercular part), inferior frontal gyrus (triangular part), inferior occipital gyrus, and right inferior frontal gyrus (triangular part) of patients with NSCLC while increased nodal strength was found in the right pallidum and thalamus. NSCLC also showed decreased nodal betweenness in the right superior occipital gyrus. Different hub regions distribution was found between groups, however, no hub regions showed group differences in the nodal measures. Furthermore, the ROC curve analysis showed good performance in distinguishing NSCLC from HC. CONCLUSION These results suggested that topological abnormalities of pallido-thalamo-cortical circuit in functional brain network might be related to NSCLC prior to chemotherapy, which provided new insights concerning the pathophysiological mechanisms of NSCLC and could serve as promising biological markers for the identification of patients with NSCLC.
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Affiliation(s)
- Siwen Liu
- Research Center for Clinical Oncology, Jiangsu Cancer Hospital, Jiangsu Institute of Cancer Research, The Affiliated Cancer Hospital of Nanjing Medical University, Nanjing, China
| | - Na Yin
- Department of Radiology, Jiangsu Cancer Hospital, Jiangsu Institute of Cancer Research, The Affiliated Cancer Hospital of Nanjing Medical University, Nanjing, China
| | - Chenchen Li
- Department of Oncology, Jiangsu Cancer Hospital, Jiangsu Institute of Cancer Research, The Affiliated Cancer Hospital of Nanjing Medical University, Nanjing, China
| | - Xiaoyou Li
- Department of Oncology, Jiangsu Cancer Hospital, Jiangsu Institute of Cancer Research, The Affiliated Cancer Hospital of Nanjing Medical University, Nanjing, China
| | - Jie Ni
- Department of Oncology, Jiangsu Cancer Hospital, Jiangsu Institute of Cancer Research, The Affiliated Cancer Hospital of Nanjing Medical University, Nanjing, China
| | - Xuan Pan
- Department of Oncology, Jiangsu Cancer Hospital, Jiangsu Institute of Cancer Research, The Affiliated Cancer Hospital of Nanjing Medical University, Nanjing, China
| | - Rong Ma
- Research Center for Clinical Oncology, Jiangsu Cancer Hospital, Jiangsu Institute of Cancer Research, The Affiliated Cancer Hospital of Nanjing Medical University, Nanjing, China
| | - Jianzhong Wu
- Research Center for Clinical Oncology, Jiangsu Cancer Hospital, Jiangsu Institute of Cancer Research, The Affiliated Cancer Hospital of Nanjing Medical University, Nanjing, China
| | - Jifeng Feng
- Research Center for Clinical Oncology, Jiangsu Cancer Hospital, Jiangsu Institute of Cancer Research, The Affiliated Cancer Hospital of Nanjing Medical University, Nanjing, China.,Department of Oncology, Jiangsu Cancer Hospital, Jiangsu Institute of Cancer Research, The Affiliated Cancer Hospital of Nanjing Medical University, Nanjing, China
| | - Bo Shen
- Department of Oncology, Jiangsu Cancer Hospital, Jiangsu Institute of Cancer Research, The Affiliated Cancer Hospital of Nanjing Medical University, Nanjing, China
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You J, Zhang J, Shang S, Gu W, Hu L, Zhang Y, Xiong Z, Chen YC, Yin X. Altered Brain Functional Network Topology in Lung Cancer Patients After Chemotherapy. Front Neurol 2021; 12:710078. [PMID: 34408724 PMCID: PMC8367296 DOI: 10.3389/fneur.2021.710078] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2021] [Accepted: 07/05/2021] [Indexed: 12/24/2022] Open
Abstract
Purpose: This study aimed to explore the topological features of brain functional network in lung cancer patients before and after chemotherapy using graph theory. Methods: Resting-state functional magnetic resonance imaging scans were obtained from 44 post-chemotherapy and 46 non-chemotherapy patients as well as 49 healthy controls (HCs). All groups were age- and gender-matched. Then, the topological features of brain functional network were assessed using graph theory analysis. Results: At the global level, compared with the HCs, both the non-chemotherapy group and the post-chemotherapy group showed significantly increased values in sigma (p < 0.05), gamma (p < 0.05), and local efficiency, Eloc (p < 0.05). The post-chemotherapy group and the non-chemotherapy group did not differ significantly in the above-mentioned parameters. At the nodal level, when non-chemotherapy or post-chemotherapy patients were compared with the HCs, abnormal nodal centralities were mainly observed in widespread brain regions. However, when the post-chemotherapy group was compared with the non-chemotherapy group, significantly decreased nodal centralities were observed primarily in the prefrontal–subcortical regions. Conclusions: These results indicate that lung cancer and chemotherapy can disrupt the topological features of functional networks, and chemotherapy may cause a pattern of prefrontal–subcortical brain network abnormality. As far as we know, this is the first study to report that altered functional brain networks are related to lung cancer and chemotherapy.
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Affiliation(s)
- Jia You
- Department of Radiology, Nanjing First Hospital, Nanjing Medical University, Nanjing, China
| | - Juan Zhang
- Department of Neurology, Nanjing Yuhua Hospital, Yuhua Branch of Nanjing First Hospital, Nanjing, China
| | - Song'an Shang
- Department of Radiology, Nanjing First Hospital, Nanjing Medical University, Nanjing, China
| | - Wei Gu
- Department of Respiratory Medicine, Nanjing First Hospital, Nanjing Medical University, Nanjing, China
| | - Lanyue Hu
- Department of Radiology, Nanjing First Hospital, Nanjing Medical University, Nanjing, China
| | - Yujie Zhang
- Department of Radiology, Nanjing First Hospital, Nanjing Medical University, Nanjing, China
| | - Zhenyu Xiong
- Department of Radiation Oncology, The University of Texas Southwestern Medical Center, Dallas, TX, United States
| | - Yu-Chen Chen
- Department of Radiology, Nanjing First Hospital, Nanjing Medical University, Nanjing, China
| | - Xindao Yin
- Department of Radiology, Nanjing First Hospital, Nanjing Medical University, Nanjing, China
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McDonald BC. Structural Neuroimaging Findings Related to Adult Non-CNS Cancer and Treatment: Review, Integration, and Implications for Treatment of Cognitive Dysfunction. Neurotherapeutics 2021; 18:792-810. [PMID: 34402034 PMCID: PMC8423886 DOI: 10.1007/s13311-021-01096-5] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/24/2021] [Indexed: 12/13/2022] Open
Abstract
Cancer- and treatment-related cognitive dysfunction (CRCD) is a common challenge faced by patients diagnosed with non-central nervous system (CNS) cancer. It has become increasingly recognized that multiple factors likely play a role in these symptoms, including the cancer disease process, systemic treatments (e.g., chemotherapy and endocrine therapies), and risk factors that may predispose an individual to both cancer and cognitive dysfunction. As the field has evolved, advanced neuroimaging techniques have been applied to better understand the neural correlates of CRCD. This review focuses on structural neuroimaging findings related to CRCD in adult non-CNS cancer populations, including examination of gray matter volume/density and white matter integrity differences between cancer patients and comparison groups, as well as emerging findings regarding structural network abnormalities. Overall, this literature has demonstrated consistent findings of reduced gray matter volume/density and white matter integrity in cancer patients relative to comparison groups. These are most prominent in individuals treated with chemotherapy, though alterations have also been noted in those treated with anti-estrogen and androgen-deprivation therapies. Alterations in gray and white matter structural network connectivity have also been identified. These structural abnormalities have been observed most prominently in frontal and temporal brain regions, and have been shown to correlate with subjective and objective cognitive function, as well as with physiological and clinical variables, helping to inform understanding of CRCD mechanisms. To date, however, structural neuroimaging techniques have not been utilized in systematic studies of potential CRCD treatments, suggesting a potentially fruitful avenue for future research.
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Affiliation(s)
- Brenna C McDonald
- Department of Radiology and Imaging Sciences, Indiana University School of Medicine and Indiana University Melvin and Bren Simon Comprehensive Cancer Center, 355 W. 16th St., GH Suite 4100, Indianapolis, IN, 46202, USA.
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Evaluation of Therapeutic Effects on Collateral Circulation in Patients with Chronic Leriche Syndrome: a Case-Control Study of Intraluminal Stent Implantation and Surgical Bypass Grafting. Cardiovasc Intervent Radiol 2021; 44:550-557. [PMID: 33447923 DOI: 10.1007/s00270-020-02766-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/03/2020] [Accepted: 12/31/2020] [Indexed: 10/22/2022]
Abstract
PURPOSE The aim of the study was to compare the hemodynamic effects of endoluminal and open surgical treatment of chronic Leriche syndrome using arterial collaterals on CTA as a surrogate parameter. MATERIALS AND METHODS This retrospective, single-center study included 30 patients with chronic Leriche syndrome. Fourteen patients underwent intraluminal stent implantation (endo group), and sixteen underwent surgical bypass grafting (surgical group). CTA was performed pre- and postoperatively, and a series of evaluation parameters (a1: sum of area of the systemic collateral pathways in the abdominal wall before operation, a2: sum of area of the systemic collateral pathways in the abdominal wall after operation, ar: area of lumen of the stent or artificial vessel, BSR: post- and preoperative blood supply ratio = (a2 + ar)/a1, RR: reduction rate of systemic collateral arteries after the operation = (a1-a2)/a1) were defined to quantitatively evaluate the hemodynamic effects of the treatments. Short-term clinical outcomes, including improvement of symptoms, postoperative complications and in-hospital stay, were also collected. Then, the effects of the two operations were compared. RESULTS There was no significant difference in the baseline (a1, p = 0.301) and postoperative (a2, p = 0.802) collateral arteries, as well as BSR (p = 0.088) and RR (p = 0.592) between endo and surgical groups. There was also no significant difference in short-term clinical outcomes between the two groups. CONCLUSION Our limited series suggests that intraluminal stent implantation may not be inferior to surgical bypass grafting regarding the undifferentiated short-term clinical outcomes as well as the chosen hemodynamic surrogate parameters.
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