String-like lumen in below-the-knee chronic total occlusions on contrast-enhanced magnetic resonance angiography predicts intraluminal recanalization and better blood flow restoration.

Zhu, Yue-Qi; Lu, Hai-Tao; Wei, Li-Ming; Liu, Fang; Cheng, Ying-Sheng; Wang, Jian-Bo; Zhao, Jun-Gong

Objectives: To determine whether string-like lumina (SLs) on contrast-enhanced magnetic resonance angiography (CE-MRA) predict better outcomes in diabetic patients with below-the-knee (BTK) chronic total occlusions (CTOs).Methods: This study involved 317 long-segment (>5 cm) BTK CTOs of 245 patients that were examined using CE-MRA and treated using endovascular angioplasty. An SL with a CTO was slowly filled with blood on conventional CE-MRA. Univariate and multivariate analyses were performed to identify predictors of procedural success, recanalisation method and immediate blood flow restoration. The target-lesion patency and limb-salvage rates were assessed.Results: SL-positive CTOs (n = 60) achieved a higher technique success rate, preferred intraluminal angioplasty and better blood flow restoration than SL-negative CTOs (n = 257, P Conclusions: In patients with BTK CTOs, SL predicted intraluminal angioplasty and good blood-flow restoration for BTK CTOs.Key Points: • Intraluminal recanalisation was more frequently used for BTK-CTOs with SLs than without • CTO length was the only independent predictor of successful CTO recanalisation • SL was the only predictor of intraluminal angioplasty for BTK-CTOs • SL and CTO length were predictors of good blood-flow restoration after recanalisation • Restenosis-free and limb-salvage rates were better for SL-positive CTOs than SL-negative CTOs.

LIMB salvage; CONTRAST-enhanced magnetic resonance imaging; BLOOD flow; KNEE surgery; ANGIOPLASTY; MULTIVARIATE analysis; BLOOD circulation; ARTERIAL occlusions; BLOOD flow measurement; HEMODYNAMICS; KNEE; LONGITUDINAL method; TIME; TREATMENT effectiveness; CONTRAST media; RETROSPECTIVE studies; MAGNETIC resonance angiography; DIAGNOSIS; PHYSIOLOGY

European Radiology, 2017, Vol 27, Issue 7, p2835

0938-7994

Academic Journal

10.1007/s00330-016-4647-1