Abstract
The aim of the present study is to assess the effects of unilateral revascularization on the contralateral foot circulation using indocyanine green (ICG). From January 2016 to April 2016, a total of twenty-one patients were included in this study. The patients underwent elective unilateral revascularization at our institution and we evaluated the feet circulation by indocyanine green angiography (ICGA) tests preoperatively and postoperatively. The ICGA parameters included the magnitude of intensity from the onset of ICG to the maximum intensity (Imax), the time from the onset of ICG to the maximum intensity (Tmax), and the time required to reach the half maximum intensity from the onset of ICG (T1/2). There were significant differences in the treated limb Tmax (P = 0.016) and T1/2 (P = 0.013) values and in the contralateral limb Tmax (P = 0.013), and T1/2 (P < 0.001) values on the perioperative ICGA tests. These results reflect the increase in skin perfusion in the treated limb and the decrease in skin perfusion in the contralateral limb. Unilateral revascularization decreases contralateral foot circulation. The preoperative contralateral lesion should be evaluated when revascularization is performed.
Highlights
Lower extremity revascularization procedures are performed in patients with peripheral arterial disease (PAD) with the aim to treat ischemia
Revascularization procedures are conducted to improve the ischemic symptoms associated with PAD
The previous reports suggested that the time needed for the progression of PAD is longer in untreated patients than in those who undergo unilateral revascularization
Summary
Lower extremity revascularization procedures are performed in patients with peripheral arterial disease (PAD) with the aim to treat ischemia. Macrovascular circulation assessments including the ABI, toe-brachial pressure index (TBI), and toe pressure (TP) can evaluate the effects of revascularization. ICG has been used to assess skin perfusion in the lower extremities of patients with PAD6–8. ICG angiography (ICGA) can evaluate the microcirculation[9,10,11,12], and the hemodynamic changes in the ipsilateral leg that occur due to unilateral revascularization might affect the microvascular circulation of the contralateral leg.
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