Intraoperative Pedal Pressure Changes Offers Another Quantitative Assessment for Revascularization

Area of Science:

• Vascular Surgery
• Interventional Cardiology
• Endovascular Interventions

Background:

• Lower extremity angiography is a common vascular procedure, typically accessed via the common femoral artery.
• Retrograde pedal artery access was historically a "bail-out" technique for chronic total occlusions.
• Increasing utilization of pedal access for primary revascularization is being reported.

Purpose of the Study:

• To describe outcomes of pedal access as a primary approach for lower extremity angiography.
• To evaluate changes in distal perfusion using direct pressure measurements after pedal access interventions.

Main Methods:

• Retrospective observational study of patients undergoing lower extremity angiography via retrograde pedal access (December 2020 - June 2021).
• Data collected: demographics, comorbidities, procedural indications, and details.
• Hemodynamic measurements (pre- and post-intervention pedal artery pressure) were recorded.

Main Results:

• 28 angiograms utilized primary pedal access; most patients were female with hypertension, diabetes, and hyperlipidemia.
• Anterior tibial artery was the most common access site (79%).
• Significant increase in mean pedal artery pressure post-intervention (36.5 mm Hg to 83.4 mm Hg, P < 0.001), with 94% technical success and no major amputations.

Conclusions:

• Primary pedal access is a feasible approach for lower extremity angiographic interventions.
• Retrograde pedal artery access leads to a significant increase in pedal artery pressure post-intervention.
• Further research is needed to correlate these findings with wound healing outcomes.