Quantitative assessment of tissue perfusion before and after peripheral angioplasty guided by perfusion angiogram, early and mid-term outcomes. A multicentre trial

Aim of the study: To evaluate the hemodynamics of contrast arrival and its tissue distribution. Also, provide objective assessment of different time-patterns both before and after endovascular intervention in patients with critical limb threatening ischemia. Moreover, to assess the technical feasibility and reproducibility of quantitative tissue perfusion in patients with peripheral artery disease through detecting changes in special tissue perfusion parameters after endovascular intervention.Material and methods: This is a multicentric prospective study conducted over a period of 2 years from 2020 to 2022, the study enrolled 16 patients presented with critical limb ischemia (CLI) and/or non-healed ulcer in which a special pre-determined protocol was applied in all patients aiming to perform endovascular procedures and perform objective assessment of tissue perfusion after the procedure guided by perfusion angiogramResults: Using the tissue perfusion parameters before and after endovascular interventions. A significant reduction was noted for arrival time (AT) (mean 6.12 pre vs. 2.29 post, P value <0.001) and time to peak (TTP) (mean 6.95 pre vs. 3.46 post, P value <0.001). Also, a significant increase was found in wash in rate (WI) (mean 10.73 pre vs. 18.81 post, P value <0.001) and area under curve (AUC) (mean 8.90 pre vs. 15.02 post, P value <0.001).Conclusion: Tissue perfusion parameters measurement is feasible and helpful to provide an endpoint for endovascular revascularization. Also, allow functional imaging that may help objectively select patients who will get benefit from additional revascularization. Moreover, applying tissue perfusion parameters is of great benefits in terms of reducing the length of the procedure, radiation exposure, and the volume of con‌trast.