Digital subtraction angiography iFlow technology for predicting major amputation in acute lower limb ischemia patients within 30 days after revascularization operation
10.13929/j.issn.1003-3289.2025.01.016
- VernacularTitle:数字减影血管造影iFlow技术预测急性下肢缺血患者接受血运重建术后30天内大截肢事件
- Author:
Ruidong LI
1
;
Chengzhi LI
1
;
Yan ZHANG
1
;
Xiaobai WANG
1
;
Wanghai LI
1
Author Information
1. 暨南大学附属第一医院介入血管外科,广东 广州 510630
- Publication Type:Journal Article
- Keywords:
ischemia;
lower extremity;
amputation,surgical;
angiography,digital subtraction
- From:
Chinese Journal of Medical Imaging Technology
2025;41(1):74-78
- CountryChina
- Language:Chinese
-
Abstract:
Objective To observe the value of digital subtraction angiography(DSA)iFlow parameters for predicting major amputation in patients with acute lower limb ischemia(ALLI)within 30 days after revascularization operation.Methods Totally 310 ALLI patients who underwent revascularization operation were retrospectively included and divided into major amputation group(n=36)and non-major amputation group(n=274)according to major amputation within 30 days after revascularization operation or not.iFlow parameters,including time to peak(TTP)and the Peak were obtained after processing of DSA images after revascularization.Receiver operating characteristic(ROC)curves were used to screen the optimal cut-off value of TTP and Peak for predicting major amputation post operation,and then TTP and Peak were dichotomized.The dichotomized TTP and Peak variables and other variables were admitted into a multivariate logistic regression to identify independent predictors of major amputation.Results TTP was higher and Peak was lower in major amputation group than those in non-major amputation group(both P＜0.05).ROC curve analysis showed that the area under the curve(AUC)of TTP and Peak for predicting major amputation within 30 days post operation was 0.831 and 0.712,respectively,and the optimal cut-off value was 16 s and 1.53,respectively.Multivariate logistic regression analysis revealed that atrial fibrillation(AF)[OR(95％CI)=3.048(1.076,8.632)],livid skin appearance[OR(95％CI)=6.035(2.323,15.677)],TTP≥16 s after revascularization operation[OR(95％CI)=8.414(3.116,22.723)]and high myoglobin levels measured 48 h after operation[OR(95％CI)=1.001(1.001,1.001)]were all independent predictors of major amputation within 30 days in ALLI patients,but dichotomized Peak variable was not an independent predictor[OR(95％CI)=0.485(0.183,1.283),P=0.145].Conclusion TTP obtained through DSA iFlow was valuable for predicting major amputation in ALLI patients within 30 days after revascularization operation.
