{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,21]],"date-time":"2026-09-21T12:09:52Z","timestamp":1789992592901,"version":"4.0.1"},"reference-count":28,"publisher":"MDPI AG","issue":"9","license":[{"start":{"date-parts":[[2026,9,18]],"date-time":"2026-09-18T00:00:00Z","timestamp":1789689600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Medicina"],"abstract":"<jats:p>Background and Objectives: Air plethysmography (APG), also referred to as pulse volume recording, provides a physiological assessment of lower-extremity perfusion, but its role in contemporary surveillance after peripheral arterial revascularization remains uncertain. This prospective study aimed to evaluate the ability of APG to monitor hemodynamic recovery and predict procedural failure after open and endovascular interventions. Materials and Methods: Consecutive patients undergoing infrainguinal revascularization for symptomatic peripheral arterial disease were prospectively enrolled and followed for 24 months. Standardized clinical assessment, ankle\u2013brachial index, Duplex ultrasonography, and APG were performed preoperatively and at 1, 6, 12, and 24 months. Longitudinal hemodynamic changes, diagnostic accuracy for restenosis, patency, and predictors of procedural failure were analyzed. Results: A total of 120 patients were included, of whom 108 (90.0%) completed a 24-month follow-up. Mean pulse volume amplitude increased from 5.8 \u00b1 2.3 mm preoperatively to 14.6 \u00b1 4.1 mm at one month (p &lt; 0.001) and remained significantly improved throughout follow-up. Systolic upstroke time decreased from 192 \u00b1 31 to 128 \u00b1 24 ms (p &lt; 0.001), while waveform morphology also improved substantially. Longitudinal analysis demonstrated a significant effect of time (p &lt; 0.001) and group-by-time interaction (p = 0.031). Among secondary outcomes, APG deterioration preceded fulfillment of the predefined Duplex criteria for significant restenosis in 26 of 34 failures, with a mean observed interval of 3.8 \u00b1 1.2 months. A \u226525% reduction in pulse volume amplitude showed good discrimination for restenosis, while APG deterioration was independently associated with procedural failure (HR = 2.80, 95% CI 1.65\u20135.37; p &lt; 0.001). Conclusions: APG is a reproducible, non-invasive surveillance adjunct that objectively reflects hemodynamic recovery and may identify physiological deterioration before fulfillment of predefined Duplex criteria for significant restenosis. These findings support further evaluation of APG as a complementary physiological modality within structured surveillance following lower-extremity revascularization.<\/jats:p>","DOI":"10.3390\/medicina62091795","type":"journal-article","created":{"date-parts":[[2026,9,21]],"date-time":"2026-09-21T10:25:43Z","timestamp":1789986343000},"page":"1795","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Prospective Evaluation of Peripheral Arterial Intervention Using Air Plethysmography"],"prefix":"10.3390","volume":"62","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0985-5032","authenticated-orcid":false,"given":"Anastasios G.","family":"Potouridis","sequence":"first","affiliation":[{"name":"2nd Department of Surgery\u2014Division of Vascular Surgery, \u201cG. Gennimatas\u201d General Hospital, Faculty of Medicine, Aristotle University of Thessaloniki, 54635 Thessaloniki, Greece"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"methodology","vocabulary":"credit"},{"role":"formal-analysis","vocabulary":"credit"},{"role":"investigation","vocabulary":"credit"},{"role":"data-curation","vocabulary":"credit"},{"role":"writing-original-draft","vocabulary":"credit"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1957-5539","authenticated-orcid":false,"given":"Dimitrios A.","family":"Chatzelas","sequence":"additional","affiliation":[{"name":"2nd Department of Surgery\u2014Division of Vascular Surgery, \u201cG. Gennimatas\u201d General Hospital, Faculty of Medicine, Aristotle University of Thessaloniki, 54635 Thessaloniki, Greece"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"formal-analysis","vocabulary":"credit"},{"role":"data-curation","vocabulary":"credit"},{"role":"writing-review-editing","vocabulary":"credit"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4999-7561","authenticated-orcid":false,"given":"Apostolos G.","family":"Pitoulias","sequence":"additional","affiliation":[{"name":"Department of Vascular and Endovascular Surgery, St Bernward Hospital, 31134 Hildesheim, Germany"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"software","vocabulary":"credit"},{"role":"validation","vocabulary":"credit"},{"role":"writing-review-editing","vocabulary":"credit"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-7240-8473","authenticated-orcid":false,"given":"Maria D.","family":"Velikoudi","sequence":"additional","affiliation":[{"name":"2nd Department of Surgery\u2014Division of Vascular Surgery, \u201cG. Gennimatas\u201d General Hospital, Faculty of Medicine, Aristotle University of Thessaloniki, 54635 Thessaloniki, Greece"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"software","vocabulary":"credit"},{"role":"writing-review-editing","vocabulary":"credit"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6862-2709","authenticated-orcid":false,"given":"Georgios A.","family":"Pitoulias","sequence":"additional","affiliation":[{"name":"2nd Department of Surgery\u2014Division of Vascular Surgery, \u201cG. Gennimatas\u201d General Hospital, Faculty of Medicine, Aristotle University of Thessaloniki, 54635 Thessaloniki, Greece"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"conceptualization","vocabulary":"credit"},{"role":"project-administration","vocabulary":"credit"},{"role":"supervision","vocabulary":"credit"},{"role":"validation","vocabulary":"credit"},{"role":"writing-review-editing","vocabulary":"credit"}]}],"member":"1968","published-online":{"date-parts":[[2026,9,18]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"e1313","DOI":"10.1161\/CIR.0000000000001251","article-title":"2024 ACC\/AHA\/AACVPR\/APMA\/ABC\/SCAI\/SVM\/SVN\/SVS\/SIR\/VESS Guideline for the Management of Lower Extremity Peripheral Artery Disease: A Report of the American College of Cardiology\/American Heart Association Joint Committee on Clinical Practice Guidelines","volume":"149","author":"Gornik","year":"2024","journal-title":"Circulation"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"132","DOI":"10.1055\/s-0037-1620242","article-title":"Current Status of Arterial Revascularization for the Treatment of Critical Limb Ischemia in Infrainguinal Atherosclerotic Disease","volume":"27","author":"Yuksel","year":"2018","journal-title":"Int. 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Res."}],"container-title":["Medicina"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1648-9144\/62\/9\/1795\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,21]],"date-time":"2026-09-21T11:26:20Z","timestamp":1789989980000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1648-9144\/62\/9\/1795"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9,18]]},"references-count":28,"journal-issue":{"issue":"9","published-online":{"date-parts":[[2026,9]]}},"alternative-id":["medicina62091795"],"URL":"https:\/\/doi.org\/10.3390\/medicina62091795","relation":{},"ISSN":["1648-9144"],"issn-type":[{"value":"1648-9144","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,9,18]]}}}