Association of 2D Perfusion Angiography and Wound Healing Rate in Combined Femoro-popliteal and Below-the-Knee Lesions in Ischemic Patients Undergoing Isolated Femoro-popliteal Endovascular Revascularization.

Abstract

The aim of this study was to demonstrate the association between 2-dimensional (2D) perfusion angiography and wound healing rate in patients with combined femoro-popliteal and below-the-knee lesions in critical limb-threatening ischemia (CLTI) and foot wounds undergoing isolated femoro-popliteal endovascular revascularization. Between January and June 2019, 24 patients with multilevel CLTI and foot wounds underwent isolated femoro-popliteal endovascular revascularization. In all of them, an assessment of foot perfusion by 2D perfusion angiography was performed. To evaluate the foot perfusion, a region of interest was identified, and time-density curves were calculated. Changes of the overall time-density curves were evaluated together with transcutaneous oximetry (TcPO2) using bivariate correlation (Pearson correlation coefficient) and associated with 6-month wound healing. The mean increase of time-density curves was 212.2% (range from +9.8% to +1984.9%) and the mean increase of TcPO2 was 116.4% (range from -4.7% to 485.7%). No significant association between time-density curves and TcPO2 values (Pearson correlation coefficient: -0.24) was observed (P = .3). At 6 months, wound healing occurred in 15 of 24 (62.5%) patients. In conclusion, this preliminary experience confirmed that 2D perfusion angiography associates with wound healing rate in CLTI patients with ischemic foot wounds and combined femoro-popliteal and below-the-knee lesions who are undergoing isolated femoro-popliteal endovascular revascularization. No association between time-density curves and TcPO2 values was observed.