Related Experiment Video
Updated: May 5, 2026
Non-invasive Assessment of Microvascular and Endothelial Function
Published on: January 29, 2013
Multi-modality imaging for assessment of the microcirculation in peripheral artery disease: Bench to clinical
Santiago Callegari1,2, Attila Feher1,3, Kim G Smolderen2,4
1Section of Cardiovascular Medicine, Department of Internal Medicine, Yale University School of Medicine, USA.
Abstract:
Peripheral artery disease (PAD) is a highly prevalent disorder with a high risk of mortality and amputation despite the introduction of novel medical and procedural treatments. Microvascular disease (MVD) is common among patients with PAD, and despite the established role as a predictor of amputations and mortality, MVD is not routinely assessed as part of current standard practice. Recent pre-clinical and clinical perfusion and molecular imaging studies have confirmed the important role of MVD in the pathogenesis and outcomes of PAD. The recent advancements in the imaging of the peripheral microcirculation could lead to a better understanding of the pathophysiology of PAD, and result in improved risk stratification, and our evaluation of response to therapies. In this review, we will discuss the current understanding of the anatomy and physiology of peripheral microcirculation, and the role of imaging for assessment of perfusion in PAD, and the latest advancements in molecular imaging. By highlighting the latest advancements in multi-modality imaging of the peripheral microcirculation, we aim to underscore the most promising imaging approaches and highlight potential research opportunities, with the goal of translating these approaches for improved and personalized management of PAD in the future.
Insights
Microvascular disease (MVD) significantly impacts peripheral artery disease (PAD) outcomes but is underassessed. Advanced imaging offers new hope for understanding MVD
Area of Science:
- Cardiology
- Vascular Medicine
- Medical Imaging
Background:
- Peripheral artery disease (PAD) is a prevalent condition associated with high mortality and amputation risks.
- Microvascular disease (MVD) is frequently observed in PAD patients and is a known predictor of adverse outcomes.
- Current standard practice does not routinely assess MVD despite its clinical significance.
Purpose of the Study:
- To review the current understanding of peripheral microcirculation anatomy and physiology.
- To discuss the role of imaging in assessing peripheral perfusion in PAD.
- To highlight recent advancements in molecular and multi-modality imaging for MVD in PAD.
Main Methods:
- Review of pre-clinical and clinical studies on perfusion and molecular imaging in PAD.
- Analysis of advancements in imaging techniques for peripheral microcirculation.
- Discussion of multi-modality imaging approaches.
Main Results:
- MVD plays a critical role in the pathogenesis and outcomes of PAD.
- Advancements in imaging can enhance understanding of PAD pathophysiology.
- Improved imaging may lead to better risk stratification and therapy evaluation.
Conclusions:
- Novel imaging techniques are crucial for understanding MVD in PAD.
- Multi-modality imaging holds promise for personalized PAD management.
- Further research in advanced imaging can improve patient outcomes.
Related Concept Videos
01:27Atherosclerosis II: Clinical Manifestations and Diagnostic Tests
01:30Peripheral Artery Disease I: Introduction
01:21Peripheral Arterial Disease II: Clinical Manifestations and Diagnostic Evaluation
01:27Peripheral Artery Disease III: Interprofessional Care
01:26Peripheral Artery Disease IV: Nursing Management
01:19Imaging Studies VII: Vascular Imaging