Michelle D.M.E. Meeks MSc, Abstract Co-Author: Research Consultant, Koninklijke Philips NV

Julie Mayer, Abstract Co-Author: Nothing to Disclose

Pascal Desgranges, Abstract Co-Author: Nothing to Disclose

K You, Abstract Co-Author: Nothing to Disclose

Jean-Francois Deux, Presenter: Nothing to Disclose

Hicham Herve Kobeiter MD, Abstract Co-Author: Nothing to Disclose

To evaluate a 2D X-ray Perfusion software to quantify infrapoplitial blood flow changes during endovascular revascularization of femoropopliteal lesions.

Fifteen patients undergoing endovascular revascularization were included in this study. Forty-one vessels were analyzed using 2D Perfusion software (Philips Healthcare, Best, The Netherlands). 2D Perfusion images could be collected after regular DSA, without additional radiation or contrast usage. A region of interest was drawn in the distal part of the 3 tibial arteries. Parameters: -time to peak (TTP), -wash in rate (WIR) and -arrival time (AT) were calculated. Parametric differences, before and after revascularization and between Rutherford classes, were statistically compared using paired and one-sample Student’s t-test, respectively.

Eight patients suffered from Rutherford class <3 and 7 from Rutherford class ≥ 3. Ten patients underwent SFA stent placement, the remaining five were treated with balloon angioplasty of the SFA and/or popliteal tibial arteries. Results demonstrated significant differences after revascularization in TTP (7% decrease), WIR (41% decrease) and AT (35% increase). Sub analysis showed a significant difference (p=0.004) in arrival time in CLI patients when compared to PAD patients, respectively a 40% decrease and 2.7% increase after revascularization.

2D Perfusion software allows for hemodynamic measurement of flow differences after endovascular revascularization. CLI patients, at rest, demonstrate a faster arrival time after revascularization when compared to PAD patients. This could be explained by the symptomatic appearance of vascular disease in PAD patients during physical exercise. Further research is needed to prove whether these hemodynamic differences are related to clinical outcome and tissue reperfusion.

2D X-ray Perfusion Software is a promising post-processing imaging technique to increase our knowledge on blood flow characteristics in patients with Peripheral Artery Disease.

Meeks, M, Mayer, J, Desgranges, P, You, K, Deux, J, Kobeiter, H, Evaluation of Infrapoplitial Blood Flow Changes During Endovascular Revascularization Using 2D X-ray Perfusion Software: A Pilot Study.  Radiological Society of North America 2014 Scientific Assembly and Annual Meeting, - ,Chicago IL. http://archive.rsna.org/2014/14006578.html