Treatment Evaluation of Flow-Limiting Stenoses of the Superficial Femoral and Popliteal Artery by Parametric Color-Coding Analysis of Digital Subtraction Angiography Series


Kostrzewa M, Kara K, Pilz L, Mueller-Muertz H, Rathmann N, Schoenberg SO, Diehl SJ.

Cardiovasc Intervent Radiol. 2017 May 9. doi: 10.1007/s00270-017-1670-9. [Epub ahead of print]



To evaluate the hemodynamic effect of percutaneous transluminal intervention (PTI) on stenosis of the superficial femoral (SFA) and popliteal arteries (PA) using time–density curves (TDCs) derived from digital subtraction angiography (DSA) series in correlation with ultrasound peak systolic velocity ratio (PSVR) and ankle brachial index (ABI).


DSA series of SFA or PA of patients with symptomatic peripheral arterial occlusive disease was obtained with a flat-panel angiography system with intention-to-treat. In DSA series acquired before and after PTI, TDCs were analyzed proximal and distal of each stenosis using parametric color coding (PCC). For correlation, ABI and PSVR measurements pre- and post-PTI were recorded for all patients.


In total, 25 stenoses of the SFA or PA were treated by PTI in 22 patients (17 male, 5 female, mean age 68 years). After treatment, peak-to-peak (PTP) times between TDCs proximal and distal to the treated vessel segment decreased statistically significantly (p = 0.01) on average from PTP = 1.9 ± 1.7 s to mean PTP = 1 ± 1 s. ABI and PSVR also changed statistically significantly after treatment (pretreatment ABI = 0.7 ± 0.2, PSVR = 4.2 ± 1.9; post-ABI = 0.9 ± 0.2, PSVR = 1.3 ± 0.4, both p\0.05). Correlation parameters did not show a strong correlation between change in TDC and clinical parameters ABI and PSVR.


Using PCC for analyzing contrast medium dynamics in DSA series is clinically useful for evaluating stenoses of the SFA and PA and for immediate treatment control after PTA.


Case series, IV

KEYWORDS: Parametric color coding; Digital subtraction angiography ; Peak systolic velocity ratio; Ankle brachial index; Peripheral arterial occlusive disease

PMID: 28488106 DOI:10.1007/s00270-017-1670-9

© Springer Science+Business Media New York and the Cardiovascular and Interventional Radiological Society of Europe (CIRSE) 2017