Arita Yoh, Ogasawara Nobuyuki, Hasegawa Shinji
Department of Cardiology, Japan Community Healthcare Organization (JCHO) Osaka Hospital, 4-2-78, Fukushima, Fukushima-ku, Osaka, 553-0003, Japan.
Cardiol Res. 2020 Dec;11(6):392-397. doi: 10.14740/cr1146. Epub 2020 Nov 2.
The ankle-brachial index (ABI), percentage of mean arterial pressure (%MAP), and upstroke time (UT) are indicators to diagnose lower-extremity peripheral artery disease (PAD). However, the respective relationship between these parameters is unknown. In this study, we analyzed the correlations between ABI, %MAP, and UT and examined their clinical usefulness for endovascular treatment (EVT).
Sixty-three consecutive subjects who underwent successful EVT for aortoiliac to femoropopliteal artery diseases were analyzed. The ABI, %MAP, and UT were measured using an automated oscillometric device.
There were significant correlations between the ABI and %MAP (r = -0.425, P < 0.001), the ABI and UT (r = -0.304, P = 0.017), and %MAP and UT (r = 0.368, P = 0.003). In terms of lesion length, there was a significant difference in %MAP after EVT (focal, 42.6%; short, 44.5%; intermediate, 47.1%; long, 49.1%; P = 0.015). There was minimal %MAP improvement in the case of a long lesion length (focal, -8.83%; short, -5.10%; intermediate, -3.00%; long, -1.50%; P = 0.006). Excessive lesion calcification also hindered %MAP improvement (grade 0, -7.16%; grade 1, -5.52%; grade 2, -4.71%; grade 3, -2.80%; grade 4, -1.00%; P = 0.049). Patients who underwent re-EVT (an average of 10.1 months after initial EVT) had minimal %MAP improvement (-2.76% vs. -5.95%, P = 0.035) at the first outpatient visit (an average of 3.3 weeks after EVT).
In conclusion, the ABI, %MAP, and UT are correlated with each other. If the length of the lesion is long and there is excessive calcification, %MAP improvement is minimal. Moreover, minimal %MAP improvement may be an indicator of future restenosis.
踝肱指数（ABI）、平均动脉压百分比（%MAP）和上升时间（UT）是诊断下肢外周动脉疾病（PAD）的指标。然而，这些参数之间各自的关系尚不清楚。在本研究中，我们分析了ABI、%MAP和UT之间的相关性，并检验了它们在血管内治疗（EVT）中的临床实用性。
对连续63例因主髂动脉至股腘动脉疾病成功接受EVT的患者进行分析。使用自动示波装置测量ABI、%MAP和UT。
ABI与%MAP之间存在显著相关性（r = -0.425，P < 0.001），ABI与UT之间存在显著相关性（r = -0.304，P = 0.017），%MAP与UT之间存在显著相关性（r = 0.368，P = 0.003）。就病变长度而言，EVT后%MAP存在显著差异（局灶性，42.6%；短病变，44.5%；中等病变，47.1%；长病变，49.1%；P = 0.015）。在病变长度较长的情况下，%MAP改善最小（局灶性，-8.83%；短病变，-5.10%；中等病变，-3.00%；长病变，-1.50%；P = 0.006）。过度的病变钙化也阻碍了%MAP的改善（0级，-7.16%；1级，-5.52%；2级，-4.71%；3级，-2.80%；4级，-1.00%；P = 0.049）。接受再次EVT的患者（初始EVT后平均10.1个月）在首次门诊就诊时（EVT后平均3.3周）%MAP改善最小（-2.76%对-5.95%，P = 0.035）。
总之，ABI、%MAP和UT相互关联。如果病变长度较长且存在过度钙化，%MAP改善最小。此外，最小的%MAP改善可能是未来再狭窄的一个指标。
