(1)背景:尽管踝臂指数(ABI)和皮肤灌注压(SPP)通常用于评估严重肢体缺血(CLI)的外周循环,它们通常不能在疼痛区域进行。我们研究了出色的微血管成像(SMI)在评估CLI患者足部灌注中的实用性。(2)方法:我们对50例行股浅动脉EVT的CLI患者进行了血管内治疗(EVT)前后,在足部六个部位测量了基于SMI的血管指数(SMI-VI),并将结果与SPP值和ABI进行了比较。(3)结果:SMI根据血管体可视化所有受试者的足部灌注,包括脚趾区域,3例血液透析患者ABI无法测量,4例患者SPP失败.CLI组的SMI-VI值显着低于对照组,足底SMI-VI对CLI的诊断性能最高(灵敏度88.6%,特异性95.6%)。EVT后,SMI-VI的增加与SPP的增加呈正相关,但与ABI无关,暗示SMI-VI反映足部微循环。(4)结论:SMI能够基于血管体实现足部微循环的可视化和定量。SMI作为评估CLI中足灌注的工具具有很高的实用性。
(1) Background: Although the ankle-brachial index (ABI) and skin perfusion pressure (SPP) are commonly used to evaluate the peripheral circulation in critical limb ischemia (CLI), they often cannot be performed on sore areas. We investigated the utility of superb microvascular imaging (SMI) for assessing foot perfusion in CLI patients. (2) Methods: We measured the SMI-based vascular index (SMI-VI) at six sites in the foot before and after endovascular treatment (EVT) in 50 patients with CLI who underwent EVT of the superficial femoral artery and compared the results with SPP values and the ABI. (3) Results: SMI visualized foot perfusion in all subjects in accordance with the angiosome, including the toe areas, while the ABI was unmeasurable in three patients on hemodialysis and SPP failed in four patients. SMI-VI values were significantly lower in the CLI group than in controls, and the plantar SMI-VI had the highest diagnostic performance for CLI (sensitivity 88.6%, specificity 95.6%). After EVT, the increase in the SMI-VI was positively correlated with the increase in SPP but not that in the ABI, implying that the SMI-VI reflects foot microcirculation. (4) Conclusions: SMI enables the visualization and quantification of foot microcirculation based on the angiosome. SMI has high utility as a tool for assessing foot perfusion in CLI.