OBJECTIVES This study investigated the correlation between vascular flow reserve (VFR) values and wound healing rate in patients with critical limb ischemia. BACKGROUND Peripheral VFR may be useful for predicting complete wound healing after endovascular therapy (EVT). However, published reports included small numbers of patients from single centers and long-term outcomes remain unknown. METHODS This was a prospective multicenter study that consecutively enrolled 104 patients (115 limbs) who received EVT for ischemic ulcerations. All lesions were treated with conventional balloon angioplasty. After EVT, VFR was measured using a pressure/temperature guidewire. The study endpoints were correlation between VFR values and wound healing rate at 3 months and 1 year. RESULTS The median VFR was 2.9. A total of 110 and 104 limbs completed the 3-month and 1-year follow-up, respectively. The 3-month and 1-year wound healing rates were 49% and 76%, respectively. VFR was significantly associated with the 3-month and 1-year wound healing (p < 0.001 for both). The crude hazard ratios of VFR (per 2-fold increase) for the 3-month and 1-year wound healing were 2.6 (1.7 to 3.9) and 2.9 (2.0 to 4.2), respectively. The estimated median time to wound healing was 5.0 (3.2 to 7.2) months, 3.3 (2.8 to 4.9) months, and 2.5 (2.0 to 3.0) months, when the VFR value was 2.4, 2.9, and 3.9, respectively. CONCLUSIONS Post-procedure VFR is significantly associated with wound healing. VFR, measured in the catheterization laboratory, is useful in clinical risk stratification for patients with critical limb ischemia after EVT. (Predictor of Wound Healing in Patients with Critical Limb Ischemia-Multicenter Prospective Study; UMIN000012746).

中文翻译：

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干预后微血管的评估，作为组织损失患者伤口愈合的预测指标。

目的本研究调查了严重肢体缺血患者的血管血流储备（VFR）值与伤口愈合率之间的相关性。背景技术外周VFR可用于预测血管内治疗（EVT）后的完全伤口愈合。但是，已发表的报告包括来自单个中心的少数患者，长期结果仍然未知。方法这是一项前瞻性多中心研究，该研究连续纳入了104例接受EVT的缺血性溃疡患者（115肢体）。所有病变均采用常规球囊血管成形术治疗。EVT后，使用压力/温度导丝测量VFR。研究终点为3个月和1年时VFR值与伤口愈合率之间的相关性。结果中位VFR为2.9。总共110和104条肢体分别完成了3个月和1年的随访。3个月和1年的伤口愈合率分别为49％和76％。VFR与3个月和1年的伤口愈合显着相关（两者均p <0.001）。3个月和1年期伤口愈合的VFR（每增加2倍）的粗略危险比分别为2.6（1.7至3.9）和2.9（2.0至4.2）。当VFR值分别为2.4、2.9和3.9时，估计的伤口愈合中位时间为5.0（3.2至7.2）个月，3.3（2.8至4.9）个月和2.5（2.0至3.0）个月。结论手术后VFR与伤口愈合显着相关。在导管实验室中测量的VFR可用于EVT后有严重肢体缺血的患者的临床风险分层。