The pulsatility index predicts the outcome after vascular interventions

Introduction The ankle-brachial index (ABI) cannot provide a high predictive accuracy for event-free survival in patients with peripheral arterial occlusion disease (PAOD).

Materials and Methods The present retrospective study investigates the predictive accuracy of hemodynamic parameters (pulsatility index [PI], resistance index [RI]) for an event-free survival (reintervention, major amputation). PI, RI and ABI measurements performed in consecutive patients with PAOD during the period from January 2012 to the end of December 2014 were assessed before and after treatment measures.

Results In the study population (n=94 patients with PAOD), event-free survival (EFS) was significantly longer in cases with post-therapeutic arteria-tibialis-posterior (PTA) PI > 1.2 vs. ≤ 1.2 (log-rank test: p= 0.005). Pairwise comparison by log-rank test showed a significant difference between the group with improved PI and the group with consistently poor values (p-value=0.046). The area(s) under the receiver operating curves (AUC of ROC curves) were significantly higher for PI compared graphically to ABI and RI. Multivariate Cox regression showed that post-therapeutic PTA-PI was the only hemodynamic parameter that influenced EFS (p=0.041).

Conclusion PI has a higher predictive accuracy for reintervention-free survival than the ABI. It should be further analyzed as a marker for an objectifying assessment of treatment success, clinical outcome, and potential for sustained therapeutic effect.

Publication History

Article published online:
20 June 2022