XXXX Plaque Analysis: A Pilot Study to Assess a Novel Tool to Predict Outcome Following Lower Limb Endovascular Intervention.

@entity1 @entity731 @entity11768 @entity256
INTRODUCTION: @entity731 plaque analysis using computed tomography angiography (CTA) has been found to be accurate and reproducible in the coronary and carotid arteries. The aim of our study was to assess the utility of this technique in predicting outcome following lower limb endovascular interventions. METHODS: Pre-procedural CTA was retrospectively analysed in 50 @entity1 who had undergone femoropopliteal (F-P) angioplasty (and/or stenting). Plaque analysis was performed using TeraRecon workstation by two observers blinded to the long-term outcome. Using the Hounsfield units (HU) scale @entity731 plaque composition was subdivided into volumes of soft (-100-100 HU) fibrocalcific (101-300 HU) or calcified (300-1000 HU) components. The relationship between plaque composition, clinical and procedural variables, and the study end points (vessel patency, binary @entity256 rate, and @entity11768 [ @entity11768 ]) were assessed using multivariate analysis. RESULTS: The technical success rate of the endovascular procedure was 98%, with 48% of @entity1 receiving F-P stents. The @entity11768 was 90%, primary patency 84%, assisted primary patency 88%, and binary @entity256 44% all at 1 year. A significantly greater total volume of calcified plaque (1.1 [.01-3.2] cm(3) vs. .11 [0-1.86] cm(3), p  <  .001) was found in @entity1 developing @entity256 (>50%) compared with those who did not. @entity1 with a calcified plaque volume greater than 1.1  cm(3) had a significantly worse @entity11768 than those with a volume less than 1.1  cm(3) (p  =  .0038). Multivariate analysis showed that the percentage calcified plaque (p  =  .003, HR 11.4, 95% CI 1.45-37.29) was an independent predictor of binary @entity256 at 12 months, and that absolute volume of calcified plaque (p  =  .001, HR 3.56, 95% CI 1.64-7.7) was independently associated with @entity11768 . CONCLUSIONS: The burden of calcified plaque, but not soft or fibrocalcific plaque is related to @entity256 , reintervention, and @entity11768 . Computed tomography plaque analysis may form an important non-invasive tool for risk stratification in @entity1 undergoing F-P endovascular procedures.
