CT perfusion in peripheral arterial disease-hemodynamic differences before and after revascularisation

Area of Science:

• Vascular Medicine
• Radiology
• Medical Imaging

Background:

• Peripheral arterial disease (PAD) significantly impacts lower extremity circulation.
• Assessing hemodynamic changes in calf muscles is crucial for PAD management.
• Interventional revascularization aims to restore blood flow in PAD patients.

Purpose of the Study:

• To evaluate the utility of volumetric CT perfusion (CTP) for assessing lower leg muscle hemodynamics.
• To compare CTP parameters before and after interventional revascularization in symptomatic PAD patients.

Main Methods:

• Prospective assessment of 29 symptomatic PAD patients undergoing interventional revascularization.
• Volumetric CT perfusion (CTP) scans of the lower leg were performed pre- and post-intervention.
• Ankle-brachial index (ABI) and angiographic assessments were conducted.
• CTP parameters (blood flow and blood volume) were calculated using a two-compartment model and no-outflow assumption.

Main Results:

• CTP imaging was feasible in patients with lower extremity PAD.
• Significant increases in blood flow (BF) and blood volume (BV) were observed in the treated limb post-revascularization (p=0.003 for BF, p=0.02 for BV).
• No significant changes in BF or BV were noted in the untreated limb.

Conclusions:

• Volumetric CT perfusion (CTP) is a feasible method for assessing hemodynamic changes in calf muscles of PAD patients.
• CTP provides quantitative, non-invasive data on the effectiveness of revascularization.
• This technique holds potential for future surveillance and therapy control in PAD management.