Gastrocnemius Echo Intensity Is Associated with Walking Distance and Hemodynamic Improvements After Endovascular Therapy in Lower Extremity Artery Disease

Background: This study aimed to validate the associations between the echo intensity (EI) of the gastrocnemius muscle before endovascular therapy (EVT) and post-EVT changes in the 6-min walk distance (6MWD), ankle–brachial index (ABI), and other skeletal muscle indicators in patients with lower extremity artery disease (LEAD). Methods: A total of 29 male patients (mean age: 73.5 years) presenting with Fontaine stage II LEAD participated in this research. The EI of the gastrocnemius muscle before EVT was assessed using ultrasonography. Based on the tertiles of EI values, participants were categorized into low (n = 10), mid (n = 10), and high (n = 9) groups. The ABI, gastrocnemius thickness, EI, and 6MWD were examined before EVT, at discharge, and at 6 months after EVT. Both cross-sectional and longitudinal comparisons were conducted across the three groups before and after EVT. Results: Before EVT, the high group demonstrated lower gastrocnemius thickness (9.0 vs. 12.7 mm, p < 0.01) and shorter 6MWD (258 vs. 391 m, p < 0.05) than the low group. At 6 months after EVT, the high group demonstrated lower ABI than the low and mid groups. The low (from 391 to 467 m, p < 0.05) and mid (from 375 to 416 m, p < 0.05) groups exhibited improvements in 6MWD. However, the high group did not (from 258 to 312 m, p = 0.1). Conclusions: EI before EVT was associated with improvements in ABI and 6MWD in patients with LEAD after EVT.