Physiological indices for evaluating balloon angioplasty outcomes in below-the-knee artery lesions of patients with chronic limb-threatening ischemia
Diagnostic and Interventional Radiology, cilt.32, sa.2, ss.208-213, 2026 (SCI-Expanded, Scopus, TRDizin)
- Yayın Türü: Makale / Tam Makale
- Cilt numarası: 32 Sayı: 2
- Basım Tarihi: 2026
- Doi Numarası: 10.4274/dir.2025.253406
- Dergi Adı: Diagnostic and Interventional Radiology
- Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus, CINAHL, EMBASE, MEDLINE, Directory of Open Access Journals, TR DİZİN (ULAKBİM)
- Sayfa Sayıları: ss.208-213
- Anahtar Kelimeler: artery, balloon angioplasty, Below-the-knee, constant resistance ratio, physiological index
- Ankara Yıldırım Beyazıt Üniversitesi Adresli: Evet
Özet
PURPOSE To assess the potential use of resting distal pressure/aortic pressure (Pd/Pa) and constant resistance ratio (cRR) physiological indices in the treatment of tibial artery lesions with balloon angioplasty in patients with chronic limb-threatening ischemia (CLTI). METHODS In this single-center retrospective study, resting Pd/Pa and cRR measurements were performed using a pressure microcatheter after balloon angioplasty. Procedures were conducted using balloons with diameters of 3 and/or 3.5 mm. The optimal group was defined as patients with either resting Pd/Pa or cRR ≥0.9, whereas the acceptable group included those with both values between 0.8 and 0.9. Clinical improvement in patients with rest pain (Rutherford 4) was defined as at least a 1-point category improvement, indicating a reduction or resolution of rest pain. RESULTS The study population consisted of 40 patients (75% men; mean age 64 ± 11.2 years), with a follow-up duration of 92 ± 40.5 days. Foot ulcers were present in 90% of the patients. During follow-up, wound healing was observed in 69.7% of patients. The optimal group exhibited higher rates of wound healing and clinical improvement than the acceptable group, although the difference was not statistically significant (80% vs. 50%, P = 0.151). No patient required target vessel revascularization. The overall limb salvage rate during follow-up was 94.6%. CONCLUSION Short-term follow-up demonstrated favorable rates of wound healing, patency, and limb salvage. The optimal group showed a trend toward improved wound healing and clinical improvement. CLINICAL SIGNIFICANCE This study highlights the utility of resting Pd/Pa and cRR as reproducible physiological indices for objectively evaluating the success of balloon angioplasty in below-the-knee arteries in patients with CLTI. Physiological assessment can guide procedural decisions, contributing to improved limb salvage and high patency rates.