ArticleJournal of vascular surgery2025
Employing magnetic resonance histology for precision chronic limb-threatening ischemia treatment planning.
Article in Journal of vascular surgery, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.
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Who cites it
5 citing papers in PubMed.
- Clinical magnetic resonance imaging-defined plaque morphology predicts guidewire crossing failure in below-the-knee occlusions in a translational model using amputated lower limbs.Journal of vascular surgery · 2026Article
- Noncontrast magnetic resonance angiography outperforms digital subtraction angiography in detecting hibernating below-the-knee arteries and downgrades Transatlantic Inter-Society Consensus and Global Limb Anatomic Staging System scores in chronic limb-threatening ischemia patients.Journal of vascular surgery · 2026Observational
- Unveiling the Sex-Based Divide: Exploring Sex Differences in Peripheral Artery Disease.Current atherosclerosis reports · 2025Review
- Developing a Scanning Electron Microscopy Approach to Evaluate Paclitaxel Deposition From Drug Coated Balloons in a Human Cadaveric Peripheral Artery Disease Model.EJVES vascular forum · 2025Article
- Innovations in MRI and AI Integration for Vascular Plaque Evaluation and Overview of Deep Learning Techniques in Peripheral Vascular Disease.Methodist DeBakey cardiovascular journal · 2025Review
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Authors and funding
7 authors.
Funding
Abstract
objectiveRecent randomized controlled trials have demonstrated a notable prevalence of immediate technical failures in percutaneous vascular interventions (PVIs) for complex arterial lesions associated with chronic limb-threatening ischemia. Current imaging modalities present inherent limitations in identifying these lesions, making it challenging to determine the most suitable candidates for PVI. We present a novel preprocedural magnetic resonance imaging (MRI) histology protocol for identifying lesions that might present a higher rate of immediate and midterm PVI failure.
methodsWe enrolled 22 patients (13 females, average age 65.8 ± 9.72 years) scheduled for PVI were prospectively and underwent 3T MRI using ultrashort echo time and steady-state free precession contrasts to characterize target lesions before PVI. Lesions were scored as hard if >50% of the lumen was occluded by hard components (calcium/dense collagen) on MRI in the hardest cross-section. Two readers evaluated MRI datasets. Trans-Atlantic Inter-Society Consensus Document on Management of Peripheral Arterial Disease (TASC)/Global Limb Anatomic Staging System (GLASS)/Wound, Ischemia and Foot infection scoring was performed based on intraprocedural angiograms and chart review. The relationship between MRI scoring, TASC/GLASS scoring, and procedural outcomes was investigated using univariate analysis. Midterm follow-up (revascularization and amputation rates) was recorded at 3 and 6 months after the intervention.
resultsOur cohort of 22 patients yielded 40 target lesions. Five lesions were excluded (two for nondiagnostic image quality; three PVIs were ultimately diagnostic only). Six lesions (17%) were scored as hard. MRI-scored hard lesions had a higher proportion of immediate technical failure (hard vs soft 83% [5/6] vs 3% [1/29]; P < .001). Hard vs soft MRI scoring was the only factor significantly associated with immediate PVI technical success (P < .001), as opposed to TASC/GLASS scoring. Both at 3 months and 6 months after PVI, the reintervention rate was significantly higher among those lesions which were scored hard on MRI (3 months hard, 80% vs soft, 16% [P =.011]; 6 months hard, 80% vs soft, 27%; P = .047).
conclusionsMRI histology could be a valuable tool for optimizing PVI patient selection and treatment strategies.
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