The Predictive Value of the Peripheral Arterial Calcium Scoring System on Computed Tomography Angiography in Patients With Chronic Limb-Threatening Ischemia Undergoing Below-the-Knee Endovascular Interventions

Both PACSS and mPACSS scored on CTA imaging are significantly associated with 3-month limb salvage and AFS after BTK endovascular interventions.Clinical ImpactCurrent peripheral calcification scores are based on angiography and limited by a low sensitivity and minimal interobserver agreement. Scoring the original and modified peripheral arterial calcium scoring system (mPACSS) on computed tomography angiography (CTA) has proven to be more reliable and fast. Accordingly, this study shows that both PACSS and mPACSS scored on CTA are independent predictors of 3-month outcomes after below-the-knee interventions. This reinforces the importance of using a reliable peripheral calcification score in the preoperative assessment of CLTI patients eligible for revascularization. Future evaluations in larger cohorts with longer follow-up should investigate the PACSS and mPACSS in different clinical contexts and whether either score is superior.