University of Oulu

M. Peltokangas et al., "Effects of Percutaneous Transluminal Angioplasty of Superficial Femoral Artery on Photoplethysmographic Pulse Transit Times," in IEEE Journal of Biomedical and Health Informatics, vol. 23, no. 3, pp. 1058-1065, May 2019. doi: 10.1109/JBHI.2018.2851388

Effects of percutaneous transluminal angioplasty of superficial femoral artery on photoplethysmographic pulse transit times

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Author: Peltokangas, Mikko1; Suominen, Velipekka2; Vakhitov, Damir2;
Organizations: 1BioMediTech Institute and Faculty of Biomedical Sciences and Engineering, Tampere University of Technology, Tampere, Finland
2Division of Vascular Surgery, Department of Surgery, Tampere University Hospital, Tampere, Finland
3Division of Interventional Radiology, Department of Radiology, Tampere University Hospital, Tampere, Finland
4Department of Surgery, Tampere University Hospital, Tampere, Finland
5Oulu University Hospital, Oulu, Finland
Format: article
Version: accepted version
Access: open
Online Access: PDF Full Text (PDF, 1.3 MB)
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Language: English
Published: Institute of Electrical and Electronics Engineers, 2019
Publish Date: 2019-09-24


We analyze the changes in upper and lower limb pulse transit times (PTT) caused by peripheral artery disease (PAD) and its treatment with percutaneous transluminal angioplasty (PTA) of the superficial femoral artery. PTTs were extracted from the photoplethysmograms (PPG) recorded from an index finger and 2nd toes. PTTs were defined between the R-peaks of the ECG and different reference points of the PPG: foot and peak points, maxima of 1st and 2nd derivative, and by means of intersecting tangents method. Also the PTTs between the toe and finger pulses were analyzed. Our sample consists of 24 subjects examined before and after the PTA and in 1-month followup visit. Also 28 older than 65 years controls having normal ankle-to-brachial pressure index (ABI) and no history in cardiovascular diseases as well as 21 younger subjects were examined. The differences between the groups and preand post-treatment phases were analyzed by means of non-parametric statistical tests. The changes in the PTTs of upper limb and non-treated lower limb were negligible. The agreement with the reference values, ABI and toe pressures, was studied by kappa-analysis, resulting in kappa-values of 0.33–0.91. Differences in PTTs were found between pretreatment state of the treated limb, post-treatment state and the follow-up visit, as well as between the pre-treatment state and controls. If patients’ age and systolic blood pressure were taken into consideration, the method of lower limb PTT calculation from the peak point turns out feasible in finding the markers of PAD and monitoring post-treatment vascular remodellation.

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Series: IEEE journal of biomedical and health informatics
ISSN: 2168-2194
ISSN-E: 2168-2208
ISSN-L: 2168-2194
Volume: 23
Issue: 3
Pages: 1058 - 1065
Article number: 8399495
DOI: 10.1109/JBHI.2018.2851388
Type of Publication: A1 Journal article – refereed
Field of Science: 3121 General medicine, internal medicine and other clinical medicine
Funding: The work was funded by the Doctoral Programme of the President of Tampere University of Technology, Business Finland as a part of project VitalSens (decision ID 40103/14), Academy of Finland as part of project Vascular Biomechanics Assessment using printed soft electronics and advanced signal processing (VBA) (decisions 310617 and 310618) and grants from Finnish Cultural Foundation/Pirkanmaa Regional Fund, Tekniikan edistämissäätiö, and Emil Aaltonen Foundation.
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