2D perfusion angiography as quantitative method to evaluate iloprost effect on foot circulation.

Area of Science:

• Vascular Medicine
• Interventional Radiology
• Medical Imaging

Background:

• Critical limb-threatening ischemia (CLTI) poses significant challenges in foot perfusion.
• Iloprost, a prostacyclin analogue, possesses vasodilating properties beneficial for circulation.
• Assessing treatment efficacy in CLTI patients requires precise perfusion evaluation.

Purpose of the Study:

• To establish 2D perfusion angiography as a quantitative tool for evaluating iloprost's impact on foot circulation.
• To assess the utility of 2D perfusion angiography in patients with CLTI undergoing endovascular revascularization and iloprost therapy.

Main Methods:

• 25 CLTI patients underwent below-the-knee endovascular revascularization followed by intra-arterial iloprost administration.
• Foot perfusion was assessed using 2D perfusion angiography before and after iloprost infusion.
• Time-density curves within a defined region of interest were analyzed to quantify perfusion changes.

Main Results:

• Endovascular revascularization was successful in all patients.
• Intra-arterial iloprost administration led to a significant increase in foot perfusion in 20 out of 25 patients (+31.6%).
• Minor complications (cutaneous rash, hypotension) occurred in 32% of patients; 5 patients showed no perfusion improvement.

Conclusions:

• 2D perfusion angiography serves as a valuable quantitative method for assessing iloprost's effect on foot circulation in CLTI patients.
• This imaging technique can differentiate between responders and non-responders to iloprost therapy.
• Intra-arterial iloprost administration is associated with a notable rate of minor complications.