腘动脉超声造影评估外周动脉疾病腔内治疗疗效的探索性研究

An explorative study on the effect of endovascular treatment for peripheral artery disease evaluated by contrast-enhanced ultrasound of popliteal artery

目的 探索腘动脉超声造影(CEUS)评估外周动脉疾病(PAD)腔内治疗(EVT)的疗效。方法 回顾性收集2019年7月—2021年6月于复旦大学附属华东医院成功接受EVT的老年PAD患者临床资料。患者完成EVT前、后的腘动脉CEUS检查,收集CEUS灌注参数(PPs)。比较EVT前、后腘动脉PPs的差异,分析PPs和踝肱指数(ABI)的相关性。结果 共入组27例老年PAD患者(27条肢体),年龄67~84岁,平均(76.8±5.5)岁,其中男性16例、女性11例。EVT技术成功率100%,临床成功率100%。与EVT前比较,EVT后ABI升高[(0.54±0.08)vs(0.79±0.11),P<0.001];EVT后峰值收缩速度加快,达峰时间(TTP)降低(P<0.001)。EVT前后峰值强度和平均通过时间差异无统计学意义(P>0.05)。术后PI与术后ABI存在弱相关(R2=0.154,P=0.043),术后TTP与术后ABI存在中等相关(R2=0.545,P<0.001)。结论 腘动脉CEUS可以用于判断PAD患者EVT的疗效,TTP可能是ABI的潜在替代指标。

Objective To explore the effect of endovascular treatment(EVT)for peripheral arterial disease(PAD)evaluated by contrast-enhanced ultrasound of the popliteal artery(CEUS).Methods The clinical data of elderly PAD patients who successfully received EVT in Huadong Hospital Affiliated to Fudan University from July 2019 to June 2021 were collected retrospectively.Before and after EVT,they underwent popliteal artery CEUS examination and their CEUS perfusion parameters(PPs)were collected.The difference of PPs of popliteal artery before and after EVT was compared,and the correlation between PPs and ankle-brachial index(ABI)was analyzed.Results A total of 27 elderly PAD patients(27 limbs)were enrolled,aged 67-84 years,with an average age of(76.8±5.5)years,including 16 males and 11 females.The technical success rate of EVT was 100%,and the clinical success rate was 100%.Compared with before EVT,ABI increased after EVT[(0.54±0.08)vs(0.79±0.11),P<0.001],the peak systolic velocity increased and the time to peak(TTP)decreased after EVT(P<0.001).There was no significant difference in peak intensity(PI)and mean transit time before and after EVT(P>0.05).There was a weak correlation between postoperative PI and postoperative ABI(R 2=0.154,P=0.043),and a moderate correlation between postoperative TTP and postoperative ABI(R 2=0.545,P<0.001).Conclusion CEUS of the popliteal artery can be used to evaluate the effect of EVT in PAD patients,and TTP may be a potential alternative indicator for ABI.