Department of Cardiology, Kishiwada Tokushukai Hospital, Kishiwada, Osaka Prefecture, Japan.
Department of Metabolic Medicine, Osaka University Graduate School of Medicine, Suita, Osaka Prefecture, Japan.
Catheter Cardiovasc Interv. 2019 Jan 1;93(1):108-112. doi: 10.1002/ccd.27813. Epub 2018 Aug 25.
To assess the efficacy of indigo carmine angiography for wound healing after successful below-the-knee intervention in patients with critical limb ischemia (CLI).
A multi-center prospective intervention study was conducted. Fifty-four limbs of 53 patients in Rutherford categories 5 and 6 underwent endovascular therapy (EVT). After successful EVT, 5 mL of indigo carmine was injected through a catheter at the distal popliteal artery and color changes in the foot were evaluated. The results of indigo carmine angiography were divided into three groups: In type I, the color change of the wound was deeper than the surrounding tissue; in type II, the change in wound color was similar to the surrounding tissue; and in type III, no discoloration of the wound was observed by the indigo carmine.
The wound healing rates at 3 months were 78% (25/32) for type I, 70% (7/10) for type II, and 42% (5/12) for type III (P for trend = 0.025). Indigo carmine angiography-related complications were not seen.
Indigo carmine angiography was found to be a safe and useful procedure to provide visual information on foot perfusion. This dye coloring method demonstrated that after successful angioplasty, the perfused area was made visible at the microcirculation level. Indigo carmine angiography can thus be considered an important predictor for wound healing by EVT in patients with CLI.
评估靛胭脂血管造影在成功治疗下肢缺血性疾病（CLI）后对下肢伤口愈合的疗效。
进行了一项多中心前瞻性干预研究。53 名患者的 54 条肢体（Rutherford 分类 5 和 6 级）接受了血管内治疗（EVT）。EVT 成功后，通过股动脉远端的导管注射 5 毫升靛胭脂，并评估足部的颜色变化。靛胭脂血管造影的结果分为三组：I 型，伤口颜色变化比周围组织深；II 型，伤口颜色变化与周围组织相似；III 型，靛胭脂未观察到伤口变色。
3 个月时的伤口愈合率分别为 I 型 78%（25/32）、II 型 70%（7/10）和 III 型 42%（5/12）（趋势 P=0.025）。未观察到与靛胭脂血管造影相关的并发症。
靛胭脂血管造影是一种安全有效的方法，可以提供足部灌注的视觉信息。这种染料染色方法表明，血管成形术后，在微循环水平上可以看到灌注区域。因此，靛胭脂血管造影可被视为 CLI 患者 EVT 后伤口愈合的重要预测指标。
