The Association of Cardio-Ankle Vascular Index and Ankle-Brachial Index in Patients with Peripheral Arterial Disease

Pulse ◽

10.1159/000515357 ◽

2021 ◽

pp. 1-6

Author(s):

Taichiro Hayase

Keyword(s):

Peripheral Arterial Disease ◽

Chronic Total Occlusion ◽

Ankle Brachial Index ◽

Arterial Disease ◽

Artery Stenosis ◽

Total Occlusion ◽

Brachial Blood Pressure ◽

Below The Knee ◽

Peripheral Arterial ◽

Stenotic Lesions

Introduction: The cardio-ankle vascular index (CAVI) is a well-known index to evaluate arterial stiffness and predict cardiovascular risk. Methods: We investigated whether CAVI can predict severity and extent of peripheral arterial disease. This study was a single-center, retrospective, observational study approved by the Ethics Committee of Yokohama Shintoshi Neurosurgical Hospital. A total of 96 patients (males, 63) with an abnormal ankle-brachial blood pressure index (ABI) of <0.9 and who underwent extremity arteriography at our hospital from 2015 to 2018 were enrolled in this study. We defined that CAVI with a range of <8.0 was normal. Results: Coronary angiography and extremity arteriography were performed for patients who had intermittent claudication and abnormal ABI. We divided the affected limbs into 3 categories: above-the-knee artery stenosis, above-the-knee artery chronic total occlusion, and only below-the-knee artery stenosis/occlusion groups. CAVI pseudonormalization was seen in 28, 76, and 19%, respectively. The above-the-knee artery stenosis and the only below-the-knee artery stenosis/occlusion groups had a high odds ratio of abnormalization of CAVI (3.1, 95% confidence interval [CI]: 1.39–7.22; p = 0.05, 4.56, 95% CI: 1.64–14.7). Discussion/Conclusion: In the presence of the above-the-knee artery chronic total occlusion, CAVI pseudonormalization was likely to be seen. The presence of CTO in the above-the-knee artery is one cause of pseudonormalized CAVI. In the range of ABI, in which stenotic lesions and obstructive lesions coexist, it may be possible to detect the existence of CTO by a combination of both ABI and CAVI.

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Efficacy of metal tip catheter for chronic total occlusion lesions in peripheral arterial disease

Cardiovascular Intervention and Therapeutics ◽

10.1007/s12928-011-0084-x ◽

2011 ◽

Vol 27 (1) ◽

pp. 19-23 ◽

Cited By ~ 1

Author(s):

Minoru Ihara ◽

Tsugiyoshi Yamazaki ◽

Masaharu Kudo ◽

Osamu Murai ◽

Yoshiaki Tsukamoto

Keyword(s):

Peripheral Arterial Disease ◽

Chronic Total Occlusion ◽

Arterial Disease ◽

Total Occlusion ◽

Metal Tip ◽

Peripheral Arterial

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TCTAP C-200 Peripheral Arterial Disease with Chronic Total Occlusion over Right Common Iliac Artery

Journal of the American College of Cardiology ◽

10.1016/j.jacc.2016.03.415 ◽

2016 ◽

Vol 67 (16) ◽

pp. S340-S342

Author(s):

Tzu Chieh Lin ◽

Chun-Yuan Chu ◽

Wen-Hsien Lee ◽

Po-Chao Hsu ◽

Ho-Ming Su ◽

...

Keyword(s):

Peripheral Arterial Disease ◽

Iliac Artery ◽

Chronic Total Occlusion ◽

Common Iliac Artery ◽

Arterial Disease ◽

Total Occlusion ◽

Peripheral Arterial

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Hallucal thenar index: A new index to detect peripheral arterial disease using laser speckle flowgraphy

Vascular ◽

10.1177/1708538120938935 ◽

2020 ◽

pp. 170853812093893

Author(s):

Kazuhiro Tsunekawa ◽

Fumio Nagai ◽

Tamon Kato ◽

Ikkei Takashimizu ◽

Daisuke Yanagisawa ◽

...

Keyword(s):

Blood Flow ◽

Peripheral Arterial Disease ◽

Operating Characteristic ◽

Ankle Brachial Index ◽

Arterial Disease ◽

Laser Speckle ◽

Laser Speckle Flowgraphy ◽

Skin Perfusion ◽

Peripheral Arterial ◽

Cutaneous Blood

Objectives Laser speckle flowgraphy is a technology using reflected scattered light for visualization of blood distribution, which can be used to measure relative velocity of blood flow easily without contact with the skin within a short time. It was hypothesized that laser speckle flowgraphy may be able to identify foot ischemia. This study was performed to determine whether laser speckle flowgraphy could distinguish between subjects with and without peripheral arterial disease. Materials and methods All subjects were classified based on clinical observations using the Rutherford classification: non-peripheral arterial disease, class 0; peripheral arterial disease group, class 2–5. Rutherford class 6 was one of the exclusion criteria. Laser speckle flowgraphy measured the beat strength of skin perfusion as an indicator of average dynamic cutaneous blood flow change synchronized with the heartbeat. The beat strength of skin perfusion indicates the strength of the heartbeat on the skin, and the heartbeat strength calculator in laser speckle flowgraphy uses the blood flow data to perform a Fourier transform to convert the temporal changes in blood flow to a power spectrum. A total of 33 subjects with peripheral arterial disease and 40 subjects without peripheral arterial disease at a single center were prospectively examined. Laser speckle flowgraphy was used to measure hallucal and thenar cutaneous blood flow, and the measurements were repeated three times. The hallucal and thenar index was defined as the ratio of beat strength of skin perfusion value on hallux/beat strength of skin perfusion value on ipsilateral thenar eminence. The Mann–Whitney U-test was used to compare the median values of hallucal and thenar index and ankle brachial index between the two groups. A receiver operating characteristic curve for hallucal and thenar index of beat strength of skin perfusion was plotted, and a cutoff point was set. The correlation between hallucal and thenar index of beat strength of skin perfusion and ankle brachial index was explored in all subjects, the hemodialysis group, and the non-hemodialysis (non-hemodialysis) group. Results The median value of the hallucal and thenar index of beat strength of skin perfusion was significantly different between subjects with and without peripheral arterial disease (0.27 vs. 0.87, respectively; P < 0.001). The median value of ankle brachial index was significantly different between subjects with and without peripheral arterial disease (0.8 vs. 1.1, respectively; P < 0.001). Based on the receiver operating characteristic of hallucal and thenar index, the cutoff was 0.4416 and the sensitivity, specificity, positive predictive value, and negative predictive value were 68.7%, 95%, 91.7%, and 77.6%, respectively. The correlation coefficients of all subjects, the hemodialysis group, and the non-hemodialysis group were 0.486, 0.102, and 0.743, respectively. Conclusions Laser speckle flowgraphy is a noninvasive, rapid, and widely applicable method. Laser speckle flowgraphy using hallucal and thenar index would be helpful to determine the differences between subjects with and without peripheral arterial disease. The correlation between hallucal and thenar index of beat strength of skin perfusion and ankle brachial index indicated that this index was especially useful in the non-hemodialysis group.

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Treatment of an external iliac artery chronic total occlusion using alternate access sites

CVIR Endovascular ◽

10.1186/s42155-019-0089-6 ◽

2019 ◽

Vol 2 (1) ◽

Author(s):

Justin Ratcliffe ◽

Mike Gorenchtein ◽

Pankaj Khullar ◽

Abel Casso Dominguez ◽

Mohan Satish ◽

...

Keyword(s):

Iliac Artery ◽

Chronic Total Occlusion ◽

External Iliac Artery ◽

Arterial Disease ◽

Patient Comfort ◽

Vascular Lesions ◽

Symptom Improvement ◽

Total Occlusion ◽

Maximal Medical Therapy ◽

Peripheral Arterial

Abstract Background With the advent of endovascular techniques, alternate sites such as the pedal and radial arteries can now be accessed when treating peripheral arterial disease to reduce procedural complications, shorten recovery time, and improve patient comfort. However, a paucity of literature exists on the availability of support devices that can be utilized during challenging cases. Case presentation A 70 year-old female patient presented for evaluation of severe lifestyle-limiting left-sided claudication refractory to maximal medical therapy. Angiography revealed a chronic total occlusion of the left external iliac artery, which was treated successfully by percutaneous intervention via a primary transpedal approach and with the assistance of the Outback® Elite re-entry device. The patient was discharged 2 h after the procedure and reported significant symptom improvement at follow-up. Conclusion This case highlights a newly adopted endovascular approach through an alternate access site and illustrates how the Outback® Elite device can be used as an adjunctive tool in the treatment of complex lower-extremity vascular lesions.

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