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Quantitative assessment of peripheral occlusive arterial diseases by color duplex sonography and blood endothelin
I Kitano1, T Sugimoto, M Okada
1Department of Surgery, Kobe University School of Medicine.
Insights
New ankle-brachial index (AVI) and ankle-brachial flow index (AFI) values correlate better with peripheral occlusive disease symptoms than ankle-brachial pressure index (API). Endothelin-1 (ET-1) levels indicate disease severity.
Area of Science:
- Vascular Medicine
- Diagnostic Imaging
- Biomarkers
Background:
- Peripheral occlusive diseases (PODs) require accurate quantitative evaluation.
- Existing diagnostic methods like ankle-brachial pressure index (API) have limitations in assessing disease severity.
Purpose of the Study:
- To evaluate peripheral occlusive diseases quantitatively using color duplex sonography.
- To assess the utility of new ankle-brachial index (AVI) and ankle-brachial flow index (AFI) values.
- To investigate the relationship between blood endothelin-1 (ET-1) levels and clinical symptoms of PODs.
Main Methods:
- Color duplex sonography was performed to measure systolic velocities and flow volumes of lower and upper extremity arteries.
- Ankle-brachial index (AVI) and ankle-brachial flow index (AFI) were calculated.
- Blood endothelin-1 (ET-1) levels were measured and correlated with clinical Fontaine classification and symptoms.
Main Results:
- AVI and AFI values decreased progressively with increasing Fontaine class (I to IV).
- Low AVI values were observed in limbs with Fontaine class > II and normal API.
- Higher ET-1 levels were found in Fontaine class III and IV, decreasing after revascularization.
Conclusions:
- New AVI and AFI values demonstrate a stronger correlation with clinical symptoms of PODs compared to API.
- Blood ET-1 levels are significantly elevated in severe PODs (Fontaine class III and IV) and decrease post-arterial reconstruction.
- AVI, AFI, and ET-1 measurements may offer novel tools for identifying patients with PODs and assessing arteriosclerosis severity.
Unlabelled:
To evaluate peripheral occlusive diseases quantitatively, we performed color duplex sonography and measured the blood endothelin (ET-1) level.
Materials And Method:
We measured the systolic velocities of the dorsal pedial and the posterior tibial arteries as well as the brachial artery. We also calculated the flow volume, and the ratio of systolic velocities and flow volume of the lower to upper extremity (AVI, AFI). Furthermore we measured the blood ET-1 level and investigated the relationship between this value and clinical symptoms.
Results:
The value of AVI as well as AFI decreased in the order of Fontaine class I, II, III and IV. In four limbs with a Fontaine class greater than II with a normal ankle pressure index, the values of AVI were low. On the other hand, three limbs with normal values of peak-AVI (> 0.9) and lower API (< 0.75) were in Fontaine class I. The value of the ET-1 level was higher in Fontaine class III and IV than in class II, and decreased after revascularization along with improvement of clinical symptoms.
Conclusions:
The new AVI and AFI values showed a better correlation with clinical symptoms than API. The ET-1 level was significantly higher in Fontaine class III and IV, and showed marked regression after arterial reconstruction. Thus, the new AVI and AFI values may provide a novel means of identifying patients with the peripheral occlusive diseases, and the measurement of ET-1 level may be potentially useful in identifying the severity of arteriosclerosis.