{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T15:51:26Z","timestamp":1791388286962,"version":"4.3.3"},"reference-count":34,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T00:00:00Z","timestamp":1791331200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T00:00:00Z","timestamp":1791331200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"name":"The Medical Science and Technology Project of Zhejiang Province","award":["2021KY393"],"award-info":[{"award-number":["2021KY393"]}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Insights Imaging"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To develop and internally validate a model using contralateral-controlled thigh muscle biomarkers, measured on routine computed tomography angiography (CTA), to predict clinically driven, DSA-confirmed 1-year restenosis after endovascular therapy for unilateral peripheral artery disease (PAD).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and methods<\/jats:title>\n                    <jats:p>In this retrospective cohort study, 378 patients with unilateral PAD undergoing endovascular therapy and having baseline and 1-year follow-up CTA were included. Mid-thigh skeletal muscle cross-sectional area and whole-thigh muscle volume were quantified bilaterally with semi-automated software. Contralateral-controlled biomarkers (affected minus contralateral) were derived to isolate limb-specific ischemic effects. The primary endpoint was clinically driven 1-year restenosis (\u2265\u200950%) confirmed by DSA.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Among 378 patients, 162 (43%) developed restenosis at a median follow-up of 12.5 months. Contralateral-controlled muscle asymmetry was independently associated with restenosis after adjustment for lesion length, baseline stenosis degree, Fontaine stage, disease duration, and TASC II classification (OR 1.43, 95% CI: 1.08\u20131.89,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.01). Adding muscle asymmetry to a severity-only model improved discrimination from AUC 0.76 to 0.79 (DeLong\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.04). A baseline predictive model combining lesion length and muscle asymmetry achieved AUC 0.74; a full explanatory model incorporating longitudinal muscle changes reached AUC 0.88, with the greatest net benefit on decision curve analysis.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Thigh muscle biomarkers, acquired opportunistically from routine CTA scans, improved the prediction of 1-year restenosis after endovascular therapy and may support targeted surveillance in patients with unilateral PAD.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Key Points<\/jats:title>\n                    <jats:p>\n                      <jats:bold>Question<\/jats:bold>\n                      Can contralateral-controlled thigh muscle biomarkers on routine CT angiography improve the prediction of 1-year restenosis after endovascular therapy for unilateral peripheral artery disease?\n                    <\/jats:p>\n                    <jats:p>\n                      <jats:bold>Findings<\/jats:bold>\n                      In 378 PAD patients, baseline contralateral thigh muscle asymmetry independently predicted clinically driven, DSA-confirmed restenosis and improved AUC from 0.76 to 0.79.\n                    <\/jats:p>\n                    <jats:p>\n                      <jats:bold>Critical relevance statement<\/jats:bold>\n                      Opportunistic contralateral-controlled thigh muscle analysis on routine CT angiography provides a no-cost imaging biomarker that refines post-endovascular restenosis risk stratification, supporting targeted angiographic surveillance and advancing personalized vascular imaging practice in peripheral artery disease.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s13244-026-02407-0","type":"journal-article","created":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T14:57:06Z","timestamp":1791385026000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Contralateral-controlled thigh muscle biomarkers on CT angiography for prediction of 1-year restenosis after endovascular therapy for unilateral peripheral artery disease"],"prefix":"10.1186","volume":"17","author":[{"given":"Shuangxiang","family":"Lin","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xinhong","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yifeng","family":"Pan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Libing","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jianzhong","family":"Sun","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5295-3140","authenticated-orcid":false,"given":"Bing","family":"Chen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,10,7]]},"reference":[{"key":"2407_CR1","doi-asserted-by":"publisher","first-page":"j5842","DOI":"10.1136\/bmj.j5842","volume":"360","author":"RL Morley","year":"2018","unstructured":"Morley RL, Sharma A, Horsch AD et al (2018) Peripheral artery disease. 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