Near-infrared spectroscopy during peripheral vascular surgery

Area of Science:

• Vascular Surgery
• Medical Technology
• Physiology

Background:

• Infrainguinal bypass surgery is crucial for limb salvage.
• Perioperative monitoring of tissue perfusion is vital for successful outcomes.
• Assessing tissue saturation changes during surgery can indicate perfusion status.

Purpose of the Study:

• To evaluate the utility of near-infrared spectroscopy (NIRS) for perioperative monitoring in infrainguinal bypass surgery.
• To assess changes in tissue saturation during and after bypass procedures.
• To determine if NIRS can detect ischemia and reperfusion events.

Main Methods:

• Near-infrared spectroscopy (dual-wavelength continuous light spectroscopy) was applied to the dorsum of the foot.
• Measurements were taken in 14 patients undergoing infrainguinal bypass (prosthesis or saphenous vein).
• Tissue saturation was monitored before, during, and after the surgical procedure, including arterial clamping and declamping.

Main Results:

• An immediate increase in tissue saturation was observed post-grafting (median 28 units, P < 0.01).
• Distal clamping of the common femoral artery induced maximal ischemia (median reduction of 61 units, P < 0.01).
• Post-declamping, tissue saturation significantly exceeded preoperative levels (median 27 units higher, P < 0.01).

Conclusions:

• Near-infrared spectroscopy (NIRS) is a suitable method for perioperative monitoring during vascular grafting.
• NIRS can detect and quantify changes in tissue saturation related to ischemia and reperfusion.
• This technology offers valuable real-time data for managing patients undergoing infrainguinal bypass surgery.