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Comprehensive imaging of microcirculatory changes in the foot during endovascular intervention - A technical

Martin Hultman1, Sofie Aronsson2, Ingemar Fredriksson3

  • 1Department of Biomedical Engineering, Linköping University, Linköping, Sweden.

Microvascular Research
|January 12, 2022
PubMed

Insights

This study introduces a new optical imaging system to monitor microcirculation during endovascular interventions for chronic limb-threatening ischemia (CLTI). The technology visualizes real-time perfusion changes, aiding treatment decisions and improving patient outcomes.

Area of Science:

  • Biomedical Engineering
  • Medical Imaging
  • Vascular Surgery

Background:

  • Chronic limb-threatening ischemia (CLTI) significantly impacts patients, with high morbidity and mortality.
  • Current endovascular treatments rely on macrocirculatory data, neglecting microcirculation, which can lead to treatment failure.
  • Impaired microvascular perfusion is a key factor in non-healing ischemic lesions post-intervention.

Purpose of the Study:

  • To present a novel multimodal optical imaging system for real-time microcirculation assessment during endovascular interventions.
  • To evaluate the system's ability to monitor spatiotemporal changes in microcirculatory perfusion and oxygen saturation.
  • To demonstrate the system's utility in guiding clinical decisions and assessing treatment efficacy in CLTI.

Main Methods:

  • Development of a multimodal imaging system combining multi-exposure laser speckle contrast imaging and multi-spectral imaging.
  • Continuous monitoring of microcirculatory perfusion and oxygen saturation during endovascular procedures.
  • Analysis of perioperative and postoperative microcirculation dynamics.

Main Results:

  • The system successfully captured physiological microcirculatory changes during balloon dilation, including induced ischemia and restored perfusion.
  • Observed expected responses to vasodilator administration, such as hyperemia.
  • Demonstrated pulsatile microcirculation patterns during perioperative and postoperative follow-up.
  • Identified spatial heterogeneity in oxygen saturation and perfusion.

Conclusions:

  • The novel multimodal imaging system is technically feasible for characterizing microcirculatory changes before, during, and after endovascular interventions.
  • Real-time microcirculation imaging offers valuable insights beyond traditional angiography.
  • This technology has the potential to improve treatment strategies and outcomes for CLTI patients.

Keywords:
Chronic limb-threatening ischemiaMicrocirculationMulti-exposure laser speckle contrast imagingMulti-spectral imaging

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