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The observation of below-the-knee artery by optical frequency domain image and angioscopy: a case series

Haruya Yamane1, Yasunori Ueda1, Kuniyasu Ikeoka1

  • 1Cardiovascular Division, NHO Osaka National Hospital, 2-1-14 Hoenzaka, Chuo-ku, Osaka, Osaka 540-0006, Japan.

European Heart Journal. Case Reports
|November 9, 2023
PubMed

Insights

Understanding non-stenotic below-the-knee (BTK) artery atherosclerosis is key to improving endovascular treatment (EVT) outcomes. This case series used optical frequency domain imaging (OFDI) and angioscopy to explore BTK artery characteristics in EVT patients.

Area of Science:

  • Vascular Surgery
  • Interventional Cardiology
  • Medical Imaging

Background:

  • Endovascular treatment (EVT) is standard for chronic limb-threatening ischemia, targeting below-the-knee (BTK) arteries.
  • High re-intervention rates necessitate a deeper understanding of BTK artery atherosclerosis.
  • This study investigates non-stenotic BTK artery atherosclerosis in EVT patients.

Observation:

  • A case series of five patients undergoing superficial femoral artery (SFA) EVT was observed.
  • Optical frequency domain imaging (OFDI) and angioscopy were used to examine the ipsilateral BTK artery.
  • Atherosclerosis severity varied, with two patients showing advanced disease and three exhibiting mild disease.

Findings:

  • Patients presented with multiple risk factors and SFA/BTK artery stenosis or occlusion.
  • Some patients with BTK artery stenosis/occlusion lacked significant atherosclerosis in the examined segment.
  • This suggests potential non-atherosclerotic mechanisms contributing to BTK artery occlusion in some cases.

Implications:

  • Findings highlight the complex nature of BTK artery disease beyond simple stenosis.
  • Further research is needed to elucidate alternative mechanisms of BTK artery occlusion.
  • Improved understanding may lead to more effective and durable EVT strategies for limb salvage.
Abstract

Keywords:
AngioscopyBelow-the-knee arteryCase reportLower extremity artery diseaseOptical frequency domain imaging

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