Perfusion Assessment in Critical Limb Ischemia: Principles for Understanding and the Development of Evidence and

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Induction and Assessment of Ischemia-reperfusion Injury in Langendorff-perfused Rat Hearts
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Induction and Assessment of Ischemia-reperfusion Injury in Langendorff-perfused Rat Hearts

Published on: July 27, 2015

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Sanjay Misra, Mehdi H Shishehbor, Edwin A Takahashi

    Circulation
    |August 13, 2019
    PubMed

    Insights

    Peripheral artery disease (PAD) affects millions, with critical limb ischemia (CLI) being its severe form. Noninvasive tests aid CLI diagnosis and management, addressing ethnic disparities.

    Area of Science:

    • Vascular Medicine
    • Diagnostic Technologies
    • Health Disparities

    Background:

    • Peripheral artery disease (PAD) impacts over 12 million Americans.
    • Critical limb ischemia (CLI), the most severe PAD form, presents diagnostic and management challenges.
    • Ethnic disparities exist in CLI comorbidities and clinical presentation.

    Purpose of the Study:

    • To review current noninvasive tests for assessing limb perfusion in CLI.
    • To highlight the importance of accurate diagnosis in managing CLI.
    • To discuss limitations and opportunities for improving CLI care and reducing health disparities.

    Main Methods:

    • Review of existing scientific literature on noninvasive limb perfusion assessment.
    • Discussion of diagnostic technologies including ankle-brachial index (ABI) and toe-brachial index (TBI).
    • Analysis of ethnic variations in CLI presentation and comorbidities.

    Main Results:

    • Noninvasive limb perfusion assessment is crucial for timely CLI diagnosis.
    • Tests like ABI and TBI help differentiate CLI from other causes of leg ulcers or pain.
    • Black and Hispanic patients show higher rates of diabetes, renal disease, and gangrene compared to white patients.

    Conclusions:

    • Accurate noninvasive assessment of limb perfusion is vital for effective CLI management.
    • Addressing ethnic disparities in CLI diagnosis and treatment is essential.
    • Further research and technological improvements are needed to enhance CLI care and reduce healthcare disparities.

    Keywords:
    AHA Scientific Statementsischemia, lower extremityperfusion imagingperipheral arterial disease

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