Hemodynamic changes of lower extremity peripheral arterial disease following interventional therapy: primary application of iFlow quantitative evaluation

Objective: To investigate the value of a new software (iFlow) for quantitative analysis of preoperative and postoperative hemodynamic change for patients with lower extremity peripheral arterial occlusive disease(PAD). Methods: A retrospective analysis for PAD interventional therapy in our hospital from March 2012 to March 2013 was performed, symptomatic PAD patients who were definitely diagnosed by CTA and successfully treated by intervention were evaluated (cases with suboptimal DSA were excluded). Sixteen cases were retrospectively reviewed in this study. Their lower extremity arteriography were equally divided into 4 consecutive segments, the lesions of stenosis and occlusion were treated with balloon dilatation and (or) stenting. Quantitative analysis of these angiographic images were carried out with iFlow software. Time to peak (TTP) were measured preoperative and postoperative respectively for the regions selected at common femoral artery bifurcation, popliteal artery bifurcation and ankle joint, in addition, the relative TTP from common femoral artery bifurcation to popliteal artery bifurcation (relative TTP of popliteal artery bifurcation) and from common femoral artery bifurcation to ankle joint (relative TTP of ankle joint) were analyzed. These parameters of above-mentioned were compared with t test. Results: The interventional operation of 16 cases were all successful, there was no complications. The preoperative and postoperative TTP of common artery bifurcation were (5.46 ± 2.69) s and (4.64 ± 0.92) s, the difference had no statistical significance (t =-1.161, P > 0.05). The TTP of popliteal artery bifurcation and ankle joint were (13.49 ± 3.96) s and (22.84 ± 7.27) s at preoperative measurement, it were decreased to (9.84 ± 2.44) s and (14.88 ± 4.56) s post operation respectively with significant statistical difference (t = -3.142 and -3.710, P < 0.01). The relative TTP of popliteal artery bifurcation and ankle joint were (8.03 ± 4.04) s and (17.38 ± 6.17) s pre operation, it were also decreased to (5.20 ± 2.42) s and (10.25 ± 4.64) s post operation respectively with significant statistical difference (t = 2.404 and 3.746, P < 0.05). Conclusion: iFlow software quantitative analysis of preoperative and postoperative hemodynamic changes for patients with lower extremity peripheral arterial disease is a reliable and promising technique. (authors)