Shao Jiang, Ma Jiangyu, Lai Zhichao, Yu Xiaoxi, Li Kang, Xu Leyin, Chen Junye, Wang Chaonan, Cao Wenteng, Liu Xiaolong, Yuan Jinghui, Liu Bao
Department of Vascular Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Science, Beijing, China.
Eight-Year Program of Clinical Medicine, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China.
Quant Imaging Med Surg. 2022 Jun;12(6):3204-3212. doi: 10.21037/qims-21-801.
The treatment strategy for patients with multiple infrapopliteal artery occlusions remains controversial. In this study, we investigated how anatomic factors affect the treatment effect of infrapopliteal artery intervention and identified suitable intervention strategies for patients with multiple infrapopliteal artery occlusions.
This was a prospective, single-center, observational cohort study. For each patient, the intrainterventional blood volume improvement of the dorsum and plantar surface was measured and classified into the direct perfused region (DR) or indirect perfused region (IR) on the basis of whether the supplying artery was revascularized. Digital subtraction angiography was performed to analyze how pedal arch patency affects blood communication between DR and IR.
A total of 38 patients treated with infrapopliteal intervention at the Department of Vascular Surgery of Peking Union Medical College Hospital from November 2016 to November 2020 were considered for inclusion in this study. Finally, 26 patients were included in the analysis. In patients with type III pedal arch, blood volume improvements for DR and IR were 70.50 (17.50, 191.75) and 11.25 (-10.25, 50.25) mL/1,000 mL, respectively (P=0.018). No significant difference was found between DR and IR in patients with type I pedal arch (P=0.208) and type II pedal arch (P=0.110).
Impaired pedal arch has an adverse impact on foot collateral circulation. Patients with these conditions are more suitable for direct revascularization than other patients.
ClinicalTrials.gov identifier: NCT03248323.
对于腘动脉以下多支动脉闭塞患者的治疗策略仍存在争议。在本研究中，我们调查了解剖因素如何影响腘动脉以下动脉介入治疗的效果，并为腘动脉以下多支动脉闭塞患者确定合适的介入策略。
这是一项前瞻性、单中心观察性队列研究。对每位患者，测量介入过程中足背和足底的血容量改善情况，并根据供血动脉是否再血管化分为直接灌注区（DR）或间接灌注区（IR）。进行数字减影血管造影以分析足弓通畅情况如何影响DR和IR之间的血液流通。
2016年11月至2020年11月在北京协和医院血管外科接受腘动脉以下介入治疗的38例患者被纳入本研究。最终，26例患者纳入分析。在III型足弓患者中，DR和IR的血容量改善分别为70.50（17.50，191.75）和11.25（-10.25，50.25）mL/1000 mL（P = 0.018）。I型足弓患者（P = 0.208）和II型足弓患者（P = 0.110）的DR和IR之间未发现显著差异。
足弓受损对足部侧支循环有不利影响。患有这些情况的患者比其他患者更适合直接血管再通。
ClinicalTrials.gov标识符：NCT03248323。
