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

IF 1.4 4区医学 Q3 PERIPHERAL VASCULAR DISEASE

Annals of vascular surgery Pub Date : 2025-02-01 DOI:10.1016/j.avsg.2024.10.019

Isadora Ísis Fernandes Vieira , Emmanuelle Tenório Albuquerque Godoi Berenguer de Barros E. Silva , Gabriela de Oliveira Buril , Carlos Henrique Nascimento Domingues da Silva , Esdras Marques Lins

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引用次数: 0

Abstract

Background

Critical limb ischemia (CLI) of the lower limbs (LLs) is a severe condition caused by peripheral arterial obstructive disease (PAOD). Surgical planning for CLI requires the study of limb circulation, and the vascular resistance index (RI) measured by Doppler ultrasound (US) has been used to aid in surgical decision-making. The objective is to correlate the RI of recipient arteries with the patency of LL revascularization surgeries in patients with CLI.

Methods

Prospective cohort study conducted from July 2021 to March 2023. The RI of the recipient arteries was evaluated preoperatively by US in 58 patients with CLI who underwent infrainguinal open or endovascular revascularizations, hospitalized in the Vascular Surgery Department of the Hospital das Clínicas of Empresa Brasileira de Serviços Hospitalares/Universidade Federal de Pernambuco. After 30 days of surgery, all patients were evaluated for the presence of pulses in the revascularized limb and the ankle brachial index (ABI) was measured in all cases. Statistical analysis was conducted with a 95% confidence level, and the Student's t-test was used to compare 2 independent samples.

Results

Clinical evaluation and ABI assessment of revascularization patency after 30 days revealed that infragenicular revascularizations that occluded had an average RI of 0.72 (SD ± 0.16), while patent revascularizations had a mean RI of 0.69 (SD ± 0.17) without statistical significance (P = 0.658).

Conclusions

Despite the lack of statistical significance, the study observed that a lower preoperative RI of the distal recipient artery was associated with greater patency of the revascularization surgery after 30 days.

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阻力指数是下肢远端动脉血管再通的预后因素。

背景：下肢严重缺血（CLI）是由外周动脉阻塞性疾病（PAOD）引起的一种严重疾病。CLI的手术计划需要对肢体循环进行研究，多普勒超声（US）测量的血管阻力指数（RI）已被用于辅助手术决策：将受体动脉RI与CLI患者LL血管再通手术的通畅性相关联：方法：2021年7月至2023年3月进行的前瞻性队列研究。58名慢性肢体缺血（CLI）患者在EBSERH/UFPE医院（HC-EBSERH/UFPE）血管外科住院，接受了腹股沟下开放或血管内血运重建手术，术前通过US对受体动脉的RI进行了评估。手术30天后，对所有患者的血管再通肢体是否有搏动进行评估，并对所有病例的踝肱指数（ABI）进行测量：结果：临床评估和 30 天后血管再通的 ABI 评估显示，闭塞的膝下血管再通平均 RI 为 0.72（sd ± 0.16），而通畅的血管再通平均 RI 为 0.69（sd ± 0.17），但无统计学意义（p = 0.658）：尽管缺乏统计学意义，但该研究观察到远端受体动脉术前 RI 较低与 30 天后血管再通手术的通畅率较高有关。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Annals of vascular surgery 医学-外科

CiteScore

3.00

自引率

13.30%

发文量

603

审稿时长

50 days

期刊介绍： Annals of Vascular Surgery, published eight times a year, invites original manuscripts reporting clinical and experimental work in vascular surgery for peer review. Articles may be submitted for the following sections of the journal: Clinical Research (reports of clinical series, new drug or medical device trials) Basic Science Research (new investigations, experimental work) Case Reports (reports on a limited series of patients) General Reviews (scholarly review of the existing literature on a relevant topic) Developments in Endovascular and Endoscopic Surgery Selected Techniques (technical maneuvers) Historical Notes (interesting vignettes from the early days of vascular surgery) Editorials/Correspondence