{
  "abstract": "Objective: 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).\n\nMaterials and methods: 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 (≥ 50%) confirmed by DSA.\n\nResults: 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: 1.08–1.89, p = 0.01). Adding muscle asymmetry to a severity-only model improved discrimination from AUC 0.76 to 0.79 (DeLong p = 0.04). 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\nConclusion: 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.\n\nKey Points: Question 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\nFindings 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\nCritical relevance statement 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.",
  "abstract_shown": true,
  "affiliations": [],
  "article_type": null,
  "arxiv": null,
  "author_total": 6,
  "authors": [
    {
      "name": "Shuangxiang Lin"
    },
    {
      "name": "Xinhong Wang"
    },
    {
      "name": "Yifeng Pan"
    },
    {
      "name": "Libing Zhang"
    },
    {
      "name": "Jianzhong Sun"
    },
    {
      "name": "Bing Chen",
      "orcid": "0000-0002-5295-3140"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/36zgzhxw1wf64.bib",
  "cited_by": 0,
  "doi": "10.1186/s13244-026-02407-0",
  "fulltext_url": null,
  "id": "36zgzhxw1wf64",
  "issns": [
    "1869-4101"
  ],
  "landing_url": "https://link.springer.com/10.1186/s13244-026-02407-0",
  "language": null,
  "licence": "CC-BY-4.0",
  "licence_label": "CC BY 4.0",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by/4.0",
  "metadata_licence": null,
  "native_subjects": [
    [
      "openalex",
      "2746|Peripheral Artery Disease Management"
    ]
  ],
  "openalex": "W7220866332",
  "pdf_url": "https://link.springer.com/content/pdf/10.1186/s13244-026-02407-0.pdf",
  "pmcid": null,
  "pmid": null,
  "published": "2026-10-07",
  "publisher": "Springer Science and Business Media LLC",
  "ris": "https://research.draconitic.com/paper/36zgzhxw1wf64.ris",
  "sources": [
    {
      "first_seen": "2026-10-30T12:20:33Z",
      "native_id": "10.1186/s13244-026-02407-0",
      "source": "crossref",
      "url": "https://link.springer.com/10.1186/s13244-026-02407-0"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "openalex:2746|Peripheral Artery Disease Management",
      "subfield": "surgery"
    }
  ],
  "title": "Contralateral-controlled thigh muscle biomarkers on CT angiography for prediction of 1-year restenosis after endovascular therapy for unilateral peripheral artery disease",
  "title_text": "Contralateral-controlled thigh muscle biomarkers on CT angiography for prediction of 1-year restenosis after endovascular therapy for unilateral peripheral artery disease",
  "type": "peer-reviewed",
  "updated_at": "2026-10-30T12:20:33Z",
  "url": "https://research.draconitic.com/paper/36zgzhxw1wf64",
  "venue": "Insights into Imaging",
  "versions": []
}