A Prospective Study on Patients with Peripheral Chronic Limb Ischemia: Assessment of Pedal Acceleration Time Pre and Post Revascularization

Background: Chronic Limb Ischemia (CLI) is a severe form of peripheral arterial disease that often requires revascularization to restore blood flow and prevent limb loss. Pedal Acceleration Time (PAT) is a non-invasive ultrasound measure of distal perfusion and may offer a reliable method to assess treatment response.
Objective: To provide a better, non-invasive diagnostic and surveillance method, especially to vulnerable groups with chronic lower limb threatening ischemia (CLTI).
Patients and Methods: This prospective cross-sectional study was carried out on 41 patients aged above 18 years old with peripheral chronic limb ischemia presenting with rest pain or tissue loss. All patients were subjected to complete history taking, general, peripheral arterial, neurological examinations, laboratory [CBC, coagulation profile and kidney function tests] and diagnostic investigations. Duplex ultrasound measurements of Pedal acceleration time (PAT) of the lateral plantar artery.
Results: High significant (P<0.001) correlation between PAT class and revascularization in patients with ulcer healing. No significant (P= 0.452) correlation between PAT class after revascularization and ABI in patients with ulcer healing. No significant (P= 0.223) correlation between PAT class before revascularization and ABI in all studied patients.
Conclusions: This study found that PAT represents a reliable diagnostic and prognostic tool for CLTI, particularly in populations where traditional assessments fail. Its ability to detect successful intervention and predict wound healing makes it a strong candidate for incorporation into vascular assessment protocols. However, further large-scale, multicenter studies are needed before it can be adopted as a standard of care.