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Correlation between computer-assisted femoral arteriography and physiological tests in hypercholesterolaemic
S Nilsson1, L Kaijser, U Erikson
1Department of Diagnostic Radiology, Akademiska Sjukhuset, Uppsala, Sweden.
Insights
Computer-assisted femoral arteriography accurately assesses atherosclerosis progression. Routine physiological tests, like ankle-arm blood pressure, effectively identify ilio-femoral arterial occlusions in hypercholesterolemic patients.
Area of Science:
- Vascular Medicine
- Radiology
- Cardiovascular Disease
Background:
- Atherosclerosis progression monitoring is crucial for clinical trials.
- Computer-assisted arteriography offers detailed arterial imaging.
- Non-invasive physiological measures are used to assess peripheral circulation.
Purpose of the Study:
- To validate computer-assisted femoral arteriography against physiological estimates for atherosclerosis studies.
- To assess the correlation between arteriographic and physiological measures of peripheral circulatory function.
- To determine the utility of physiological tests in detecting ilio-femoral arterial occlusions.
Main Methods:
- 114 hypercholesterolemic patients underwent aorto-femoral arteriography and physiological tests (blood pressure, oscillometry, plethysmography, exercise tests).
- Arteriograms were digitized to calculate lumen volume, percent stenosis, and edge roughness.
- Linear and logistic regression models were used to analyze correlations and detect occlusions.
Main Results:
- Arterial lumen volume and percent stenosis from arteriography correlated significantly with most physiological variables.
- Systolic blood pressure (ankle-arm ratio) was the strongest predictor of arterial occlusions.
- Logistic regression models demonstrated high sensitivity and specificity for detecting ilio-femoral occlusions using physiological data.
Conclusions:
- Digitized femoral arteriography provides valid measures (lumen volume, stenosis) that correlate well with physiological variables.
- Physiological tests reflect atherosclerosis status in peripheral and other arterial beds.
- Routine physiological tests are effective for identifying patients with ilio-femoral arterial occlusions.
Abstract:
The validity of computer-assisted femoral arteriography, for the study of regression/progression of atherosclerosis in follow-up clinical trials, was investigated by comparison with routine physiological estimates of peripheral circulatory function. Thus, in 114 hypercholesterolaemic patients, the results of aorto-femoral arteriography were compared with those of leg segmental blood pressure measurement, oscillometry, digital pulse plethysmography, and bicycle and treadmill exercise tests. In 107 patients, 18 with symptoms of peripheral vascular disease (PVD) and 89 asymptomatic, magnification arteriograms of a 20 cm segment of the right or left superficial femoral artery were obtained. These arteriograms were digitized and the following variables were calculated: arterial lumen volume (corrected for body size), per cent stenosis, and edge roughness. The correlation between arteriographic and physiological variables was investigated with a linear regression model, taking into account the possible interaction with sex, and presence or absence of symptoms of PVD. Lumen volume correlated significantly with all five physiological variables, and per cent stenosis correlated significantly with four of the physiological variables. For the roughness measure, however a significant correlation was found only with plethysmography. By using logistic multiple regression analysis linear functions of physiological variables were constructed to detect ilio-femoral arterial occlusion. The sensitivity/specificity for detection of right-sided, left-sided, and bilateral occlusion was 0.83/0.98, 0.78/0.98, and 0.60/1.00 respectively (N = 108-111). Systolic blood pressure (ankle-arm ratio) was the single variable most closely correlated to the likelihood of arterial occlusions. It is concluded that arterial lumen volume and per cent stenosis, measured for the digitized femoral arteriogram, correlate well with physiological variables, which reflect the state of atherosclerosis both in the femoral arteries and in other arterial beds including the heart, and that routine physiological tests can be used to identify patients with arterial occlusions in the iliac and femoral arteries.