Augmentation Index as a Marker of Vascular Recovery After Endovascular Therapy in Peripheral Artery Disease

Hakan İskender1, Bahadır Omar2, İsmail Balaban1, Elnur Alizade1, Selçuk Pala1

1Department of Cardiology, Koşuyolu Training and Research Hospital, İstanbul, Türkiye
2Department of Cardiology, Vm Medical Park Pendik Hospital, İstanbul, Türkiye

Keywords: Peripheral arterial disease; pulse wave analysis; vascular stiffness.

Abstract

Objective: The objective of the study was to evaluate early changes in the aortic augmentation index (AIX) standardized to 75 bpm following successful peripheral endovascular revascularization in patients with peripheral artery disease (PAD).

Methods: This was a single-center, retrospective observational study. AIX was measured at baseline (pre-procedure), 24 h, and 1 month after the procedure using radial applanation tonometry (SphygmoCor®) under standardized conditions. Time effect was assessed with repeated-measures Analysis of Variance (ANOVA) (Greenhouse–Geisser correction if needed) and a linear mixed-effects model (random intercept for patient). Pairwise comparisons (pre–24 h, pre–1 mo, 24 h–1 mo) were adjusted by Holm; Cohen’s dz was reported as effect size.

Results: Thirty-seven patients were analyzed. Mean AIX values were 30.6 (pre), 21.4 (24 h), and 21.1 (1 month). The time effect was significant (Repeated Measures ANOVA, p<0.001). In the mixed model (pre as reference), AIX decreased at 24 h (β=-9.243±1.256, p<0.001) and at 1 month (β=-9.459±1.256, p<0.001). Pairwise contrasts confirmed significant reductions from baseline to 24 h and to 1 month, but not between 24 h and 1 month.

Conclusion: Peripheral revascularization is associated with a rapid and sustained reduction in AIX, with most of the improvement achieved within 24 h and maintained at 1 month, suggesting early favorable changes in wave reflection and arterial stiffness.

Cite This Article: İskender H, Omar B, Balaban İ, Alizade E, Pala S. Augmentation Index as a Marker of Vascular Recovery After Endovascular Therapy in Peripheral Artery Disease. Koşuyolu Heart J 2026;29(1):16–20