Department of Surgery, Leiden University Medical Center, The Netherlands.
Department of Interventional Radiology, Leiden University Medical Center, The Netherlands.
Angiology. 2024 Oct;75(9):884-892. doi: 10.1177/00033197231186096. Epub 2023 Jun 26.
Contemporary quality control methods are often insufficient in predicting clinical outcomes after revascularization in lower extremity arterial disease (LEAD) patients. This study evaluates the potential of near-infrared fluorescence imaging with indocyanine green to predict the clinical outcome following revascularization. Near-infrared fluorescence imaging was performed before and within 5 days following the revascularization procedure. Clinical improvement was defined as substantial improvement of pain free walking distance, reduction of rest- and/or nocturnal pain, or tendency toward wound healing. Time-intensity curves and 8 perfusion parameters were extracted from the dorsum of the treated foot. The quantified postinterventional perfusion improvement was compared within the clinical outcome groups. Successful near-infrared fluorescence imaging was performed in 72 patients (76 limbs, 52.6% claudication, 47.4% chronic limb-threatening ischemia) including 40 endovascular- and 36 surgical/hybrid revascularizations. Clinical improvement was observed in 61 patients. All perfusion parameters showed a significant postinterventional difference in the clinical improvement group (-values <.001), while no significant differences were seen in the group without clinical improvement (-values .168-.929). Four parameters demonstrated significant differences in percentage improvement comparing the outcome groups (-values within .002-.006). Near-infrared fluorescence imaging has promising additional value besides clinical parameters for predicting the clinical outcome of revascularized LEAD patients.
当代的质量控制方法往往不足以预测下肢动脉疾病（LEAD）患者血运重建后的临床结果。本研究评估了吲哚菁绿近红外荧光成像预测血运重建后临床结果的潜力。近红外荧光成像在血运重建术前后 5 天内进行。临床改善定义为无痛行走距离的显著改善、休息时和/或夜间疼痛的减轻或伤口愈合的趋势。从治疗足部的背面提取时间-强度曲线和 8 个灌注参数。在临床结果组内比较了定量的介入后灌注改善情况。在 72 名患者（76 条肢体，52.6%跛行，47.4%慢性肢体威胁性缺血）中成功进行了近红外荧光成像，包括 40 例血管内和 36 例手术/杂交血运重建。61 名患者观察到临床改善。在临床改善组中，所有灌注参数在介入后均显示出显著差异（-值<.001），而在无临床改善组中则未观察到显著差异（-值.168-.929）。与临床结果组相比，有四个参数在百分比改善方面显示出显著差异（-值在.002-.006 之间）。近红外荧光成像除了临床参数外，对预测血运重建的 LEAD 患者的临床结果具有有前景的附加价值。
