Authors
Masayuki Tokunaga, Masamitsu Suhara, Hiroyuki Nagita, Hiroyuki Saigusa, Keitaro Sakai, Masaki Okada, Yuichi Suzuki, Shiori Amemiya, Toshihiro Hayashi, Katsuyuki Hoshina, Osamu Abe
Published in
Annals of vascular diseases. Volume 19. Issue 1. Epub Oct 20, 2026.
Abstract
Peripheral arterial disease (PAD) symptoms can worsen with knee flexion. We examined whether time-enhancement curve (TEC) analysis of discarded bolus tracking data could detect positional differences in popliteal arrival.
In this secondary analysis of a dedicated research protocol (not routine practice), 22 patients with PAD underwent bilateral lower-extremity CT angiography in extended and flexed positions, at ≈90-degree and at maximum flexion. Arrival time, rise rate, and initial area under the curve (iAUC) were extracted. The flexed and extended limbs were compared with Wilcoxon signed-rank tests.
At maximum flexion, the flexed limb showed a median arrival delay of +1.5 s (p = 0.0002); the within-subject increase from 90-degree flexion to maximum flexion was significant (+0.5 s; p = 0.018). Exploratory subgroup analysis showed significant delays at both angles in unilateral (contralateral ankle-brachial index ≥0.9; n = 15) but not bilateral PAD (n = 7). The rise rate and iAUC did not differ.
The flexed (affected) limb showed delayed popliteal arrival, which was greater at maximum flexion. Because limb position and disease severity were confounded by design, this association is not evidence of causation. These preliminary findings support the feasibility of bolus tracking-derived TEC analysis and motivate within-limb repeated-measures studies.
PMID:
42920465
Bibliographic data and abstract were imported from PubMed on 24 Oct 2026.
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