Skin microcirculation in peripheral arterial obliterative disease.

Area of Science:

• Vascular Medicine
• Dermatology
• Medical Physiology

Background:

• Microcirculation plays a crucial role in peripheral arterial obliterative disease (PAOD) pathophysiology and symptoms.
• Non-invasive techniques like capillaroscopy, laser Doppler (LD) fluxmetry, and transcutaneous oxygen tension (tcPO2) measurement have advanced PAOD research.

Purpose of the Study:

• To investigate the role of skin microcirculation in different stages of PAOD.
• To analyze microcirculatory adaptations and deteriorations using advanced non-invasive methods.

Main Methods:

• Utilized capillaroscopy, laser Doppler (LD) fluxmetry, and transcutaneous oxygen tension (tcPO2) measurements.
• Analyzed basal and post-ischemic skin perfusion and flowmotion in PAOD patients.
• Assessed endothelial, neurogenic, myogenic, and sympathetic activities through spectral analysis of LD tracings.

Main Results:

• Stage II PAOD patients show normal basal skin perfusion but abnormal flowmotion, indicating early microcirculatory adaptation.
• Post-ischemia, stage II PAOD patients exhibit impaired hyperemia and reduced capillary blood flow.
• Critical limb ischemia (CLI) demonstrates advanced microcirculatory deterioration, with severely impaired hyperemia, reduced tcPO2, and perturbed skin flowmotion.

Conclusions:

• Skin microcirculation is significantly altered in PAOD, with distinct changes observed in stage II and critical limb ischemia.
• An integrated diagnostic approach using microcirculatory parameters can improve PAOD patient management.