Real-Time Perfusion Assessment with Hyperspectral Imaging After Revascularization in Peripheral Artery Disease

Area of Science:

• Vascular Surgery
• Medical Imaging
• Biomedical Engineering

Background:

• Peripheral arterial disease (PAD) management requires effective tissue perfusion assessment.
• Hyperspectral imaging (HSI) offers noninvasive perfusion evaluation, but lacks validation against standard methods.
• Existing HSI studies often use small cohorts or single measurements, limiting clinical applicability.

Purpose of the Study:

• To prospectively evaluate changes in tissue perfusion using HSI and transcutaneous oxygen pressure (TcPO2) after revascularization in PAD patients.
• To compare HSI parameters (StO2, NIR, THI) with TcPO2 measurements.
• To correlate HSI and TcPO2 findings with clinical improvement post-revascularization.

Main Methods:

• Prospective cohort study involving patients with Rutherford category 3-6 PAD.
• Tissue perfusion assessed via HSI and TcPO2 one day before and 1-3 days after revascularization.
• Correlation analysis between HSI parameters, TcPO2, and clinical improvement.

Main Results:

• Significant improvements observed in StO2 (+12%) and NIR (+9%) via HSI, and in TcPO2 (+16.2 mmHg).
• No significant change in Tissue Hemoglobin Index (THI) detected by HSI.
• No correlation found between HSI parameters and TcPO2 or clinical outcomes; some HSI measurements showed worsening despite successful revascularization.

Conclusions:

• While StO2, NIR, and TcPO2 improved post-revascularization, HSI parameters did not correlate with TcPO2 or clinical results.
• A significant discrepancy exists between HSI findings and established measures (TcPO2, clinical status), raising concerns about HSI's validity and clinical relevance for assessing postoperative perfusion.
• The study questions the utility of TIVITA®-based HSI for evaluating revascularization outcomes in PAD.