The role of dynamic contrast-enhanced MRI in the evaluation of percutaneous transluminal angioplasty outcome in patients with critical limb ischemia

Congress:

ECR 2020

Poster Number:

C-03729

Type:

Scientific Exhibit

Keywords:

Performed at one institution, Diagnostic or prognostic study, Prospective, Obstruction / Occlusion, Ischaemia / Infarction, Arteriosclerosis, Stents, Recanalisation, Angioplasty, MR-Diffusion/Perfusion, MR, Fluoroscopy, Vascular, Cardiovascular system, Arteries / Aorta, Interventional Radiology

Authors:

N. Galanakis, T. G. Maris, N. Kontopodis, C. Ioannou, A. H. Karantanas, D. Tsetis; Heraklion/GR

DOI:

10.26044/ecr2020/C-03729

DOI-Link:

https://dx.doi.org/10.26044/ecr2020/C-03729

Fig. 3: Box-and-whisker plots depicting the median values and the quartile ranges of...

Fig. 1: Co-registration of anatomic T1w sequence with Ktrans parametric map of the foot...

Fig. 2: Co-registration of anatomic T1w sequence with Kep parametric map of the foot...

Purpose

Peripheral arterial disease (PAD) describes the impairment of blood flow to the extremities as a result of stenoses and/or occlusions of the lower limb arteries [1]. Evaluation of PAD includes clinical history, physical examination, measurement of ankle-brachial index (ABI) and imaging studies such as color duplex ultrasound (CDUS), computed tomography angiography (CTA), magnetic resonance angiography (MRA) and digital subtraction angiography (DSA) These imaging modalities provide significant information about the distribution of macrovascular lesions of the limbs (stenoses, occlusions) but not for the local microvascular perfusion...

Methods and materials

Study design This is a prospective single-center study aiming to examine the role of DCE-MRI in the evaluation of hypoperfusion in patients with CLI and the changes of quantitative parameters after PTA. Exclusion criteria were all common contraindications to MRI, like pacemakers, ferromagnetic implants, claustrophobia and contraindications for administration of Gadolinium contrast medium. The study was approved by the local ethic committee and all patients signed informed consent prior to examination. Study population Between March 2015 and April 2017, 8 patients (5 male, 3 female)...

Results

Clinical outcome Technical success was achieved in all patients (8/8) and there were no major complications after endovascular treatment. There was significant clinical improvement in all patients and the ankle brachial index (ABI) increased from 0.35 ± 0.2 to 0.76 ± 0.25 after revascularization (p

Conclusion

DCE-MRI is a safe and reproducible technique for the diagnosis of foot hypo-perfusion. It seems also to be a promising tool for evaluation of PTA outcome, as significant restitution of perfusion parameters was observed after successful revascularization. The information may aid the efficient selection of the revascularization strategy and reliable prediction of the outcome in patients with CLI.

Personal information and conflict of interest

N. Galanakis; Heraklion/GR - nothing to disclose T. G. Maris; Heraklion/GR - nothing to disclose N. Kontopodis; Heraklion/GR - nothing to disclose C. Ioannou; Heraklion/GR - nothing to disclose A. H. Karantanas; Heraklion/GR - nothing to disclose D. K. Tsetis; Heraklion/GR - nothing to disclose

References

1. Peach G, Griffin M, Jones KG, Thompson MM, Hinchliffe RJ. Diagnosis and management of peripheral arterial disease. Bmj. 2012;345:e5208. 2 . Norgren L, Hiatt WR, Dormandy JA, Nehler MR, Harris KA, Fowkes FG et al. Inter-Society Consensus for the Management of Peripheral Arterial Disease (TASC II). European journal of vascular and endovascular surgery : the official journal of the European Society for Vascular Surgery. 2007;33 Suppl 1:S1-75. 3. Provenzale JM, Mukundan S, Barboriak DP. Diffusion-weighted and perfusion MR imaging for brain tumor characterization and...