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Resistance Index as a Prognostic Factor for Patency in Distal Lower Limb Arterial Revascularization

Isadora Ísis Fernandes Vieira1, Emmanuelle Tenório Albuquerque Godoi Berenguer de Barros E Silva1, Gabriela de Oliveira Buril2

  • 1Programa de Pós-Graduação em Cirurgia da Universidade Federal de Pernambuco, Recife, PE, Brazil.

Annals of Vascular Surgery
|November 25, 2024
PubMed

Insights

A lower preoperative vascular resistance index (RI) in recipient arteries may predict successful lower limb revascularization surgery for critical limb ischemia (CLI). This study found a trend towards better outcomes with lower RI values.

Area of Science:

  • Vascular Surgery
  • Diagnostic Ultrasound
  • Medical Imaging

Background:

  • Critical limb ischemia (CLI) is a severe manifestation of peripheral arterial obstructive disease (PAOD).
  • Accurate surgical planning for CLI necessitates thorough assessment of limb circulation.
  • Vascular resistance index (RI) via Doppler ultrasound aids surgical decision-making in CLI.

Purpose of the Study:

  • To investigate the correlation between the recipient artery's vascular resistance index (RI) and the patency of lower limb revascularization surgeries in patients with CLI.

Main Methods:

  • Prospective cohort study (July 2021-March 2023) of 58 CLI patients undergoing infrainguinal revascularization.
  • Preoperative Doppler ultrasound measured recipient artery RI.
  • Postoperative assessment at 30 days included pulse evaluation and ankle-brachial index (ABI).

Main Results:

  • Patients with occluded revascularizations had a mean RI of 0.72 (SD ± 0.16).
  • Patients with patent revascularizations had a mean RI of 0.69 (SD ± 0.17).
  • The difference in RI between occluded and patent revascularizations was not statistically significant (P=0.658).

Conclusions:

  • A lower preoperative RI of the distal recipient artery showed a trend towards association with improved revascularization surgery patency at 30 days.
  • While not statistically significant, RI may offer insights into surgical success for CLI.
  • Further research could explore the predictive value of RI in complex vascular interventions.
Abstract

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