Vascular and Endovascular Review

VOLUME 6, 2023

The Role of Targeted Infra-popliteal Endovascular Angioplasty to Treat Diabetic Foot Ulcers Using the Angiosome Model: A Systematic Review

VOLUME 7, 2024

Integration of AI and Machine Learning in Predicting Outcomes of Endovascular Aneurysm Repair

Tayyeba
Department of Microbiology and Molecular Genetics, University of Okara, Pakistan.
Shaher Bano
Department of life sciences and education, University of South Wales, UK.

Abstract

One of the most common side effects following endovascular aortic repair (EVAR) is endo-leaks, which can result in subsequent rupture and higher rates of reintervention. Cross-sectional imagination with manual axile dimensions has historically been used for the necessary serial lifetime monitoring. Imaging analysis based on artificial intelligence (AI) has been created and might offer a quicker and more accurate evaluation. The goal of this study is to determine an AI-based program's ability to detect endo-leaks, link them with EVAR-related bad outcomes, and evaluate post-EVAR morphological modifications over time. Patients who had EVAR at a tertiary hospital between January 2017 and March 2020 and had at least two follow-up computed tomography angiography (CTA) assessments were evaluated using PRAEV Aorta 2 (Nurea). The program was tested against the ground truth supplied by human experts utilizing Sensitivity (Se), Specificity (Sp), Negative Predictive Value (NPV), and Positive Predictive Value (PPV). Adverse events associated with endovascular aortic repair were characterized as limb occlusion, endo-leak, rupture, aneurysm-related mortality, and EVAR-related re-interventions. A thorough anatomic description of aorta remodeling following EVAR was made possible by the AI-based program PRAEV Aorta, which also demonstrated interest in automatically detecting endo-leaks during follow-up. When compared to maximal diameter, the correlation between aortic aneurysmal volume and EVAR-related adverse events and endo-leaks was stronger.

Keywords : Integration (II), AI, Machine Learning (ML), Predicting Outcomes (PO), Endovascular Aneurysm Repair (EAR).
Erin Saricilar
Lecture in accounting. University of Basrah, College of Administration and Economics, Department of Accounting.
Mark Yang
Lecture in accounting. University of Basrah, College of Administration and Economics, Department of Accounting.

Abstract

Atherosclerotic disease significantly impacts patients with type 2 diabetes, who often present with recalcitrant peripheral ulcers. The angiosome model of the foot presents an opportunity to perform direct angiosome-targeted endovascular interventions to maximise both wound healing and limb salvage. A systematic review was performed, with 17 studies included in the final review. Below-the-knee endovascular interventions present significant technical challenges, with technical success depending on the length of lesion being treated and the number of angiosomes that require treatment. Wound healing was significantly improved with direct angiosome-targeted angioplasty, as was limb salvage, with a significant increase in survival without major amputation. Indirect angioplasty, where the intervention is applied to collateral vessels to the angiosomes, yielded similar results to direct angiosome-targeted angioplasty. Applying the angiosome model of the foot in direct angiosome-targeted angioplasty improves outcomes for patients with recalcitrant diabetic foot ulcers in terms of primary wound healing, mean time for complete wound healing and major amputation-free survival.
Keywords : Diabetic foot ulcer, angiosome, angioplasty