Measurement of Revascularization Effect Using Near Infrared Spectroscopy in Below the Knee Arteries.

Area of Science:

• Vascular Surgery
• Medical Imaging
• Diabetic Complications

Background:

• Current ischemia evaluation focuses on blood flow, insufficient for diabetes-related small vessel disease.
• Chronic total occlusions (CTO) in below-the-knee (BTK) arteries pose significant challenges.
• Assessing tissue perfusion is crucial for managing chronic limb-threatening ischemia (CLTI).

Purpose of the Study:

• To evaluate the feasibility of near-infrared spectroscopy (NIRS) for measuring perfusion changes during BTK CTO revascularization.
• To determine if NIRS can detect perfusion improvements post-revascularization.
• To assess the correlation between intraoperative NIRS measurements and wound healing outcomes.

Main Methods:

• Prospective observational study involving 30 patients with Rutherford 5 CLTI.
• Three NIRS sensors used to monitor tissue oxygenation during endovascular revascularization.
• Postoperative angiography and 30-day wound healing assessments conducted.

Main Results:

• A statistically significant increase in NIRS measurements was observed near the wound post-revascularization (p=0.001).
• Intraoperative NIRS increase differed significantly between good and poor wound healing groups (p=0.017).
• 30-day follow-up included 27 patients; 3 patients died during the period.

Conclusions:

• NIRS is a feasible tool for detecting tissue perfusion increases during BTK artery revascularization.
• Intraoperative NIRS measurements can predict wound healing outcomes in CLTI patients.
• NIRS offers a valuable method for assessing perfusion in complex peripheral artery disease.