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Tang M, Zeng F, Chang X, He M, Fang Q, Xue L, Luo X, Yin S. Feasibility study of Syngo iFlow in predicting hemodynamic improvement post-endovascular procedure in peripheral artery disease. BMC Cardiovasc Disord 2024; 24:99. [PMID: 38341562 PMCID: PMC10858483 DOI: 10.1186/s12872-024-03762-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2023] [Accepted: 02/02/2024] [Indexed: 02/12/2024] Open
Abstract
OBJECTIVE This study endeavors to examine the feasibility of predicting the clinical outcomes of patients suffering from peripheral artery disease (PAD) who undergo endovascular intervention, by employing the Syngo iFlow technology. METHODS Retrospectively enrolling 76 patients from December 2021 to May 2023, yielding a total of 77 affected limbs, this study employs clinical outcomes (improvement or otherwise) as the gold standard. Two physicians conducted visual assessments on both DSA and iFlow images to gauge patient improvement and assessed inter-observer consistency for each image modality. The Time to Peak (TTP) of regions of interest (ROI) at the femoral head, knee joint, and ankle joint was measured. Differences in pre- and post-procedure TTP were juxtaposed, and statistically significant parameter cutoff values were identified via ROC analysis. Employing these cutoffs for TTP classification, multivariate logistic regression and the C-statistic were utilized to assess the predictive value of distinct parameters for clinical success. RESULTS Endovascular procedure exhibited technical and clinical success rates of 82.58 and 75.32%, respectively. Diagnostic performance of iFlow image visual assessment surpassed that of DSA images. Inter-observer agreement for iFlow and DSA image evaluations was equivalent (κ = 0.48 vs 0.50). Post-classification using cutoff values, multivariate logistic regression demonstrated the statistical significance of ankle joint TTP in post-procedure iFlow images of the endovascular procedure for clinical success evaluation (OR 7.21; 95% CI 1.68, 35.21; P = 0.010), with a C-statistic of 0.612. CONCLUSION Syngo iFlow color-encoded imagery holds practical value in assessing the technical success of post-endovascular procedures, offering comprehensive lower limb arterial perfusion visualization. Its quantifiable parameters exhibit promising potential for prognosticating clinical success.
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Affiliation(s)
- Ming Tang
- Department of Interventional Vascular Medicine, Hefei Hospital Affiliated to Anhui Medical University, The Second People's Hospital of Hefei, 574 Changjiang East Road, Yaohai District, Hefei City, 230011, Anhui Province, China
- The Fifth Clinical College of Medicine, Anhui Medical University, 1166 Wangjiang West Road, Shushan District, Hefei City, 230011, Anhui Province, China
| | - Fanyi Zeng
- Department of Interventional Vascular Medicine, Hefei Hospital Affiliated to Anhui Medical University, The Second People's Hospital of Hefei, 574 Changjiang East Road, Yaohai District, Hefei City, 230011, Anhui Province, China
| | - Xindong Chang
- Department of Interventional Vascular Medicine, Hefei Hospital Affiliated to Anhui Medical University, The Second People's Hospital of Hefei, 574 Changjiang East Road, Yaohai District, Hefei City, 230011, Anhui Province, China
| | - Mingfei He
- Department of Interventional Vascular Medicine, Hefei Hospital Affiliated to Anhui Medical University, The Second People's Hospital of Hefei, 574 Changjiang East Road, Yaohai District, Hefei City, 230011, Anhui Province, China
| | - Qingqing Fang
- Department of Interventional Vascular Medicine, Hefei Hospital Affiliated to Anhui Medical University, The Second People's Hospital of Hefei, 574 Changjiang East Road, Yaohai District, Hefei City, 230011, Anhui Province, China
| | - Lele Xue
- Department of Interventional Vascular Medicine, Hefei Hospital Affiliated to Anhui Medical University, The Second People's Hospital of Hefei, 574 Changjiang East Road, Yaohai District, Hefei City, 230011, Anhui Province, China
| | - Xinyi Luo
- Department of Interventional Vascular Medicine, Hefei Hospital Affiliated to Anhui Medical University, The Second People's Hospital of Hefei, 574 Changjiang East Road, Yaohai District, Hefei City, 230011, Anhui Province, China
| | - Shiwu Yin
- Department of Interventional Vascular Medicine, Hefei Hospital Affiliated to Anhui Medical University, The Second People's Hospital of Hefei, 574 Changjiang East Road, Yaohai District, Hefei City, 230011, Anhui Province, China.
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Ichihashi S, Fujimura N, Utsunomiya M, Bolstad F, Nakai T, Iwakoshi S, Tanaka T. Hemodynamic evaluation of lower limbs in patients with chronic limb-threatening ischemia. Cardiovasc Interv Ther 2022; 37:635-640. [PMID: 35941316 DOI: 10.1007/s12928-022-00883-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2022] [Accepted: 08/01/2022] [Indexed: 11/29/2022]
Abstract
Revascularization plays an important role in the treatment of chronic limb-threatening ischemia. Evaluation of hemodynamic compromise in the lower extremity is required to optimize the treatment strategy for each patient. A variety of methods have been reported to detect arterial obstruction or impaired foot perfusion. This article reviews each method, clarifying features and limitations.
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Affiliation(s)
- Shigeo Ichihashi
- Department of Diagnostic and Interventional Radiology, Nara Medical University, 840 Shijyocho, Kashihara, Nara, 634-8521, Japan.
| | - Naoki Fujimura
- Division of Vascular Surgery, Saiseikai Central Hospital, Tokyo, Japan
| | - Makoto Utsunomiya
- Division of Cardiovascular Medicine, Toho University Ohashi Medical Center, Tokyo, Japan.,TOWN Homecare Clinic, Tokyo, Japan
| | - Francesco Bolstad
- Department of Clinical English, Nara Medical University, Nara, Japan
| | - Takahiro Nakai
- Department of Diagnostic and Interventional Radiology, Nara Medical University, 840 Shijyocho, Kashihara, Nara, 634-8521, Japan
| | - Shinichi Iwakoshi
- Department of Diagnostic and Interventional Radiology, Nara Medical University, 840 Shijyocho, Kashihara, Nara, 634-8521, Japan
| | - Toshihiro Tanaka
- Department of Diagnostic and Interventional Radiology, Nara Medical University, 840 Shijyocho, Kashihara, Nara, 634-8521, Japan
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