Góg István, Sótonyi Péter, Nemes Balázs, Kiss János P, Szigeti Krisztián, Osváth Szabolcs, Gyánó Marcell
Department of Vascular and Endovascular Surgery, Heart and Vascular Center, Semmelweis University, Városmajor utca 68, 1122 Budapest, Hungary.
Kinepict Health Ltd., Szilágyi Erzsébet fasor 31, 1027 Budapest, Hungary.
J Imaging. 2024 Oct 18;10(10):260. doi: 10.3390/jimaging10100260.
The evaluation of hemodynamic conditions in critical limb-threatening ischemia (CLTI) patients is inevitable in endovascular interventions. In this study, the performance of color-coded digital subtraction angiography (ccDSA) and the recently developed color-coded digital variance angiography (ccDVA) was compared in the assessment of key time parameters in lower extremity interventions. The observational study included 19 CLTI patients who underwent peripheral vascular intervention at our institution in 2020. Pre- and post-dilatational images were retrospectively processed and analyzed by a commercially available ccDSA software (Kinepict Medical Imaging Tool 6.0.3; Kinepict Health Ltd., Budapest, Hungary) and by the recently developed ccDVA technology. Two protocols were applied using both a 4 and 7.5 frames per second acquisition rate. Time-to-peak (TTP) parameters were determined in four pre- and poststenotic regions of interest (ROI), and ccDVA values were compared to ccDSA read-outs. The ccDVA technology provided practically the same TTP values as ccDSA (r = 0.99, R = 0.98, < 0.0001). The correlation was extremely high independently of the applied protocol or the position of ROI; the r value was 0.99 (R = 0.98, < 0.0001) in all groups. A similar correlation was observed in the change in passage time (r = 0.98, R = 0.96, < 0.0001). The color-coded DVA technology can reproduce the same hemodynamic data as a commercially available DSA-based software; therefore, it has the potential to be an alternative decision-supporting tool in catheter labs.
在血管腔内介入治疗中，评估严重肢体缺血（CLTI）患者的血流动力学状况是必不可少的。在本研究中，比较了彩色编码数字减影血管造影（ccDSA）和最近开发的彩色编码数字方差血管造影（ccDVA）在评估下肢介入治疗关键时间参数方面的性能。该观察性研究纳入了2020年在我们机构接受外周血管介入治疗的19例CLTI患者。术前和扩张后的图像通过商用ccDSA软件（Kinepict Medical Imaging Tool 6.0.3；Kinepict Health Ltd.，布达佩斯，匈牙利）和最近开发的ccDVA技术进行回顾性处理和分析。使用每秒4帧和7.5帧的采集速率应用了两种方案。在四个狭窄前和狭窄后的感兴趣区域（ROI）确定达峰时间（TTP）参数，并将ccDVA值与ccDSA读数进行比较。ccDVA技术提供的TTP值与ccDSA几乎相同（r = 0.99，R = 0.98，P < 0.0001）。无论应用的方案或ROI的位置如何，相关性都极高；所有组的r值均为0.99（R = 0.98，P < 0.0001）。在通过时间的变化方面也观察到了类似的相关性（r = 0.98，R = 0.96，P < 0.0001）。彩色编码DVA技术可以再现与基于DSA的商用软件相同的血流动力学数据；因此，它有可能成为导管实验室中一种替代的决策支持工具。
