AUTHOR=Kwan Tak W. , Lee Samuel , Lin Patricia , Liou Michael , Siu Henry , Patel Apurva , Ruzsa Zoltan 

TITLE=Tibio-pedal arterial pressure assessment during endovascular intervention to improve quality-of-life in patients with intermittent claudication

JOURNAL=Frontiers in Cardiovascular Medicine

VOLUME=9

YEAR=2022

URL=https://www.frontiersin.org/journals/cardiovascular-medicine/articles/10.3389/fcvm.2022.1038353

DOI=10.3389/fcvm.2022.1038353

ISSN=2297-055X

ABSTRACT=<sec><title>Objective</title><p>The aim of this study is to compare the quality-of-life (QOL) outcomes and the tibio-pedal arterial pressure post-endovascular intervention.</p></sec><sec><title>Background</title><p>Physiological assessment of peripheral arterial lesions is infrequently performed during endovascular interventions.</p></sec><sec><title>Materials and methods</title><p>We retrospectively reviewed all 343 patients with intermittent claudication who underwent an endovascular intervention <italic>via</italic> tibio-pedal artery access from October 2018 to May 2021. The baseline and post-intervention tibio-pedal arterial pressures from the pedal sheaths were measured. QOL was assessed using a pre-validated Walking Impairment Questionnaire (WIQ) score before and at 30-day after intervention. We compared the baseline tibio-pedal arterial pressure, post-intervention tibio-pedal arterial pressure, delta pressure (post-intervention minus baseline), baseline WIQ scores, 30-day WIQ scores, and delta score (30-day minus baseline).</p></sec><sec><title>Results</title><p>All 343 patients had successful tibio-pedal accesses. The average tibio-pedal arterial pressure at baseline was 87.0 ± 1.8 mmHg vs. 135.5 ± 1.7 mmHg post-intervention (<italic>p</italic> &lt; 0.001). Average baseline and 30-day WIQ scores were summation (99.8 ± 3.3 vs. 115.0 ± 3.1, <italic>p</italic> &lt; 0.001), walking distance (35.7 ± 1.3 vs. 42.5 ± 1.3, <italic>p</italic> &lt; 0.001), walking speed (21.1 ± 0.9 vs. 23.6 ± 0.8, <italic>p</italic> = 0.036), stair climbing (4.7 ± 1.4 vs. 24.2 ± 1.4, <italic>p</italic> = 0.019), and symptoms (18.8 ± 0.2 vs. 20.1 ± 0.2, <italic>p</italic> &lt; 0.001), respectively. When comparing the increased post-intervention tibio-pedal arterial pressure &lt;60 mmHg vs. ≥60 mmHg, the average delta WIQ scores were all significantly improved with summation (10.0 ± 3.9 to 25.8 ± 5.5, <italic>p</italic> = 0.01), walking distance (4.1 ± 1.7 to 9.8 ± 2.5, <italic>p</italic> = 0.02), walking speed (1.5 ± 1.1 to 4.3 ± 1.5, <italic>p</italic> = 0.02), stair climbing (2.3 ± 1.8 to 9.4 ± 2.5, <italic>p</italic> = 0.02), and symptoms (1.0 ± 0.3 to 1.8 ± 0.4, <italic>p</italic> = 0.04), respectively.</p></sec><sec><title>Conclusion</title><p>Increasing the post-intervention tibio-pedal arterial pressure by 60 mmHg can enhance QOL as suggested by improvement of WIQ scores.</p></sec>