Endovascular Revascularization Improves the Central Hemodynamics and Augmentation Index in Patients with Peripheral
Ken Watanabe1, Hiroki Takahashi1, Tetsu Watanabe1
1Department of Cardiology, Pulmonology, and Nephrology, Yamagata University School of Medicine, Japan.
Insights
Endovascular therapy (EVT) significantly reduces central blood pressure (CBP) and augmentation index (AIx) in peripheral artery disease (PAD) patients. These improvements were consistent across different lesion types and locations.
Area of Science:
- Cardiovascular Medicine
- Vascular Surgery
- Interventional Radiology
Background:
- Peripheral artery disease (PAD) is associated with increased cardiovascular risk.
- Central blood pressure (CBP) and augmentation index (AIx) are markers of arterial stiffness and cardiovascular risk.
- Endovascular therapy (EVT) is a common treatment for PAD.
Purpose of the Study:
- To evaluate the impact of EVT on CBP and AIx in PAD patients.
- To compare the effects of EVT on different lesion types (stenotic vs. occlusive) and locations (iliac vs. superficial femoral artery).
Main Methods:
- Sixty consecutive PAD patients undergoing EVT for de novo lesions were enrolled.
- CBP and AIx were measured using radial applanation tonometry before and after EVT.
- Statistical analysis compared pre- and post-EVT values and analyzed differences based on lesion characteristics.
Main Results:
- EVT significantly decreased both CBP (125±22 to 112±22 mmHg, p=0.002) and AIx (84%±16% to 73%±15%, p<0.001).
- The therapeutic effects on CBP and AIx were similar for stenotic and occlusive lesions.
- No significant differences in EVT's effect on CBP and AIx were observed between iliac and superficial femoral artery lesions.
Conclusions:
- EVT effectively improves CBP and AIx in PAD patients.
- The benefits of EVT on arterial hemodynamics are independent of lesion morphology or location.
Abstract:
Objective To evaluate the effect of endovascular therapy (EVT) on the central blood pressure (CBP) and augmentation index (AIx) in patients with peripheral artery disease (PAD). Methods The CBP and AIx were assessed by radial applanation tonometry the day before and the day after EVT. We compared the differences in the therapeutic effects between the stenotic and occlusive lesions and between the iliac and superficial femoral artery (SFA) lesions. Patients We enrolled 60 consecutive patients with PAD who underwent EVT for de novo lesions. Results Both the CBP and AIx were significantly decreased after EVT (125±22 mmHg to 112±22 mmHg; p=0.002 and 84%±16% to 73%±15%; p<0.001, respectively). The effects of EVT on the CBP and AIx were equivalent, regardless of whether the target lesion was the stenotic lesion or the occlusive lesion. There were no significant differences between the iliac and SFA lesions in the effects of EVT on the CBP and AIx. Conclusion EVT improved the CBP and AIx in patients with PAD, regardless of the morphology or site of the lesions.
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