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Functional hemodynamics assessment during endovascular Tibio‐pedal retrograde intervention of peripheral arterial disease
Author(s) -
Kwan Tak W.,
Parikh Sahil,
Patel Apurva,
Htun Wah Wah,
Shah Sooraj,
Huang Yili,
Liou Michael,
Ruzsa Zoltan
Publication year - 2019
Publication title -
catheterization and cardiovascular interventions
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.988
H-Index - 116
eISSN - 1522-726X
pISSN - 1522-1946
DOI - 10.1002/ccd.28337
Subject(s) - medicine , brachial artery , cuff , ankle , peripheral , arterial disease , hemodynamics , cardiology , blood pressure , surgery , vascular disease
Objective We sought to use a novel technique to measure the functional hemodynamics of peripheral arterial lesions during endovascular interventions. Background Functional hemodynamics has not been thoroughly evaluated during endovascular interventions. The aim of our study is to evaluate the feasibility and the potential benefits of pedal pressures measurements from tibio‐pedal access. Methods We retrospectively reviewed 100 consecutive patients who underwent endovascular interventions via tibio‐pedal artery access between October 3, 2018 and December 15, 2018. Baseline and postintervention pedal pressures from the pedal sheaths were measured. We also evaluated the pedal‐brachial index (PBI) which is defined as the pedal sheath pressure divided by the simultaneously brachial cuff pressure. We compared baseline pedal pressures, postintervention pedal pressures, baseline PBI, postintervention PBI, % change of PBI ([postintervention PBI minus baseline PBI]/baseline PBI), and resting ankle‐brachial index (ABI) versus baseline PBI in this cohort of patients. Results All 100 patients had successful tibio‐pedal artery access. Baseline pedal pressure was 70 + 30 mmHg with post intervention pedal pressure of 133 + 27 mmHg ( p < .001). Baseline PBI was 0.75 + 0.24 with post intervention PBI of 1.09 + 0.19 ( p < .001). The correlation coefficient of resting ABI vs. baseline PBI was 0.55. The % change of PBI was 63.2 + 52.4%. There was significant improvement of postintervention PBI when compared to baseline PBI in the majority of patients. Conclusions Obtaining pedal pressures and PBI from tibio‐pedal access can be a feasible tool for endovascular interventions. This simple technique can provide us important functional hemodynamics information before and after peripheral revascularization.