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

ObjectiveThe aim of this study is to compare the quality-of-life (QOL) outcomes and the tibio-pedal arterial pressure post-endovascular intervention. BackgroundPhysiological assessment of peripheral arterial lesions is infrequently performed during endovascular interventions. Materials and methodsWe retrospectively reviewed all 343 patients with intermittent claudication who underwent an endovascular intervention via 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). ResultsAll 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 (p < 0.001). Average baseline and 30-day WIQ scores were summation (99.8 +/- 3.3 vs. 115.0 +/- 3.1, p < 0.001), walking distance (35.7 +/- 1.3 vs. 42.5 +/- 1.3, p < 0.001), walking speed (21.1 +/- 0.9 vs. 23.6 +/- 0.8, p = 0.036), stair climbing (4.7 +/- 1.4 vs. 24.2 +/- 1.4, p = 0.019), and symptoms (18.8 +/- 0.2 vs. 20.1 +/- 0.2, p < 0.001), respectively. When comparing the increased post-intervention tibio-pedal arterial pressure <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, p = 0.01), walking distance (4.1 +/- 1.7 to 9.8 +/- 2.5, p = 0.02), walking speed (1.5 +/- 1.1 to 4.3 +/- 1.5, p = 0.02), stair climbing (2.3 +/- 1.8 to 9.4 +/- 2.5, p = 0.02), and symptoms (1.0 +/- 0.3 to 1.8 +/- 0.4, p = 0.04), respectively. ConclusionIncreasing the post-intervention tibio-pedal arterial pressure by 60 mmHg can enhance QOL as suggested by improvement of WIQ scores.