Monitoring of Foot Oxygenation with Near-infrared Spectroscopy in Patients with Critical Limb Ischemia Undergoing Percutaneous Transluminal Angioplasty: A Pilot Study

Objective Near-infrared spectroscopy (NIRS) non-invasively determines tissue oxygen saturation (St o2 ) in muscle tissue. Its application to monitor real time hemodynamic changes during percutaneous transluminal angioplasty (PTA) and St o2 changes in feet 4 weeks after PTA was evaluated. Methods Thi...

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Veröffentlicht in:European journal of vascular and endovascular surgery 2016-11, Vol.52 (5), p.650-656
Hauptverfasser: Boezeman, R.P.E, Becx, B.P, van den Heuvel, D.A.F, Ünlü, Ç, Vos, J.A, de Vries, J.P.P.M
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container_end_page 656
container_issue 5
container_start_page 650
container_title European journal of vascular and endovascular surgery
container_volume 52
creator Boezeman, R.P.E
Becx, B.P
van den Heuvel, D.A.F
Ünlü, Ç
Vos, J.A
de Vries, J.P.P.M
description Objective Near-infrared spectroscopy (NIRS) non-invasively determines tissue oxygen saturation (St o2 ) in muscle tissue. Its application to monitor real time hemodynamic changes during percutaneous transluminal angioplasty (PTA) and St o2 changes in feet 4 weeks after PTA was evaluated. Methods This study included 14 patients with critical limb ischemia (CLI, six patients Rutherford classification Stage IV, two patients Stage V, and six patients Stage VI). In patients with arterial ulcers, NIRS optodes were placed near the ulcer of the diseased foot (Optode 1), and at the same spot at the contralateral foot (Optode 2). In patients without arterial ulcers, Optode 1 was placed on the dorsum of the diseased foot, and Optode 2 was placed on the dorsum of the contralateral foot. Single St o2 values, ankle brachial indices, and toe brachial indices were obtained at rest before the start of endovascular revascularization and 4 weeks after treatment. During the endovascular procedure, continuous St o2 measurements were recorded throughout the intervention. Completion angiograms were used to evaluate the success of intervention. Results Patients underwent treatment of the superficial femoral artery (79%), popliteal artery (21%), and below the knee arteries (43%). In 13 of the 14 patients, completion angiograms showed successful treatment of target lesions. Ankle brachial indices and toe brachial indices significantly increased 4 weeks after treatment (both p  
doi_str_mv 10.1016/j.ejvs.2016.07.020
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Its application to monitor real time hemodynamic changes during percutaneous transluminal angioplasty (PTA) and St o2 changes in feet 4 weeks after PTA was evaluated. Methods This study included 14 patients with critical limb ischemia (CLI, six patients Rutherford classification Stage IV, two patients Stage V, and six patients Stage VI). In patients with arterial ulcers, NIRS optodes were placed near the ulcer of the diseased foot (Optode 1), and at the same spot at the contralateral foot (Optode 2). In patients without arterial ulcers, Optode 1 was placed on the dorsum of the diseased foot, and Optode 2 was placed on the dorsum of the contralateral foot. Single St o2 values, ankle brachial indices, and toe brachial indices were obtained at rest before the start of endovascular revascularization and 4 weeks after treatment. During the endovascular procedure, continuous St o2 measurements were recorded throughout the intervention. Completion angiograms were used to evaluate the success of intervention. Results Patients underwent treatment of the superficial femoral artery (79%), popliteal artery (21%), and below the knee arteries (43%). In 13 of the 14 patients, completion angiograms showed successful treatment of target lesions. Ankle brachial indices and toe brachial indices significantly increased 4 weeks after treatment (both p  &lt; .01). Single St o2 values of Optode 1 also significantly increased four weeks after treatment ( p  &lt; .01). In contrast, single St o2 values of Optode 2 did not ( p  = .73). During the endovascular procedure, continuous St o2 measurements of Optode 1 and 2 did not increase ( p  = .80, and p  = .61, respectively). Conclusions NIRS monitoring of foot oxygenation in patients undergoing endovascular revascularization is safe and feasible. NIRS is a promising non-invasive technique to monitor hemodynamic changes in the feet of CLI patients after endovascular treatment using single St o2 values.</description><identifier>ISSN: 1078-5884</identifier><identifier>EISSN: 1532-2165</identifier><identifier>DOI: 10.1016/j.ejvs.2016.07.020</identifier><identifier>PMID: 27614555</identifier><language>eng</language><publisher>England: Elsevier Ltd</publisher><subject>Angioplasty ; Lower extremity ; Muscles ; Near-infrared spectroscopy ; Peripheral arterial disease ; Surgery</subject><ispartof>European journal of vascular and endovascular surgery, 2016-11, Vol.52 (5), p.650-656</ispartof><rights>European Society for Vascular Surgery</rights><rights>2016 European Society for Vascular Surgery</rights><rights>Copyright © 2016 European Society for Vascular Surgery. Published by Elsevier Ltd. 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Its application to monitor real time hemodynamic changes during percutaneous transluminal angioplasty (PTA) and St o2 changes in feet 4 weeks after PTA was evaluated. Methods This study included 14 patients with critical limb ischemia (CLI, six patients Rutherford classification Stage IV, two patients Stage V, and six patients Stage VI). In patients with arterial ulcers, NIRS optodes were placed near the ulcer of the diseased foot (Optode 1), and at the same spot at the contralateral foot (Optode 2). In patients without arterial ulcers, Optode 1 was placed on the dorsum of the diseased foot, and Optode 2 was placed on the dorsum of the contralateral foot. Single St o2 values, ankle brachial indices, and toe brachial indices were obtained at rest before the start of endovascular revascularization and 4 weeks after treatment. During the endovascular procedure, continuous St o2 measurements were recorded throughout the intervention. Completion angiograms were used to evaluate the success of intervention. Results Patients underwent treatment of the superficial femoral artery (79%), popliteal artery (21%), and below the knee arteries (43%). In 13 of the 14 patients, completion angiograms showed successful treatment of target lesions. Ankle brachial indices and toe brachial indices significantly increased 4 weeks after treatment (both p  &lt; .01). Single St o2 values of Optode 1 also significantly increased four weeks after treatment ( p  &lt; .01). In contrast, single St o2 values of Optode 2 did not ( p  = .73). During the endovascular procedure, continuous St o2 measurements of Optode 1 and 2 did not increase ( p  = .80, and p  = .61, respectively). Conclusions NIRS monitoring of foot oxygenation in patients undergoing endovascular revascularization is safe and feasible. NIRS is a promising non-invasive technique to monitor hemodynamic changes in the feet of CLI patients after endovascular treatment using single St o2 values.</description><subject>Angioplasty</subject><subject>Lower extremity</subject><subject>Muscles</subject><subject>Near-infrared spectroscopy</subject><subject>Peripheral arterial disease</subject><subject>Surgery</subject><issn>1078-5884</issn><issn>1532-2165</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2016</creationdate><recordtype>article</recordtype><recordid>eNp9Uk1v1DAUjBCIlsIf4IB85JLgjzjJIoS0WlGotNCVtj1bjvOydUjs1HYK-UP8ThylcODAye8wM34z85LkNcEZwaR412XQPfiMxjnDZYYpfpKcE85oSknBn8YZl1XKqyo_S15432GMOWH8eXJGy4LknPPz5NdXa3SwTpsTsi26tDag65_zCYwM2hr0Q4c79A2kS7VpnXTQoOMIKjjrlR1npA06RCSY4FfszumglezRXg81uvLqDgYt0a1pwJ3s8s0BnJqCNGAnj26cNL6fBm0iZWtO2o699GF-j7booPu4zTFMzfwyedbK3sOrx_ciub38dLP7ku6vP1_ttvtURTshLWVOWZVXCssck7qtSwY5KagslIRKlbUkXErMak4xo4Q0CudtXhZtualhwyp2kbxddUdn7yfwQQzaK-j7dV1BKk4LzktCI5SuUBWz8A5aMTo9SDcLgsXSj-jE0o9Y-hG4FLGfSHrzqD_VAzR_KX8KiYAPKwCiywcNTngV01XQaBdjF43V_9f_-A9d9dosfXyHGXxnJxeDjj6EpwKL43Ihy4GQguFobMN-A4KSuc4</recordid><startdate>20161101</startdate><enddate>20161101</enddate><creator>Boezeman, R.P.E</creator><creator>Becx, B.P</creator><creator>van den Heuvel, D.A.F</creator><creator>Ünlü, Ç</creator><creator>Vos, J.A</creator><creator>de Vries, J.P.P.M</creator><general>Elsevier Ltd</general><scope>6I.</scope><scope>AAFTH</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0003-3614-9168</orcidid></search><sort><creationdate>20161101</creationdate><title>Monitoring of Foot Oxygenation with Near-infrared Spectroscopy in Patients with Critical Limb Ischemia Undergoing Percutaneous Transluminal Angioplasty: A Pilot Study</title><author>Boezeman, R.P.E ; Becx, B.P ; van den Heuvel, D.A.F ; Ünlü, Ç ; Vos, J.A ; de Vries, J.P.P.M</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c455t-7a423848c0a401bfb73e4162a6cae8c7ba15aa03b5203211dc04f476f79be9383</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2016</creationdate><topic>Angioplasty</topic><topic>Lower extremity</topic><topic>Muscles</topic><topic>Near-infrared spectroscopy</topic><topic>Peripheral arterial disease</topic><topic>Surgery</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Boezeman, R.P.E</creatorcontrib><creatorcontrib>Becx, B.P</creatorcontrib><creatorcontrib>van den Heuvel, D.A.F</creatorcontrib><creatorcontrib>Ünlü, Ç</creatorcontrib><creatorcontrib>Vos, J.A</creatorcontrib><creatorcontrib>de Vries, J.P.P.M</creatorcontrib><collection>ScienceDirect Open Access Titles</collection><collection>Elsevier:ScienceDirect:Open Access</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>European journal of vascular and endovascular surgery</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Boezeman, R.P.E</au><au>Becx, B.P</au><au>van den Heuvel, D.A.F</au><au>Ünlü, Ç</au><au>Vos, J.A</au><au>de Vries, J.P.P.M</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Monitoring of Foot Oxygenation with Near-infrared Spectroscopy in Patients with Critical Limb Ischemia Undergoing Percutaneous Transluminal Angioplasty: A Pilot Study</atitle><jtitle>European journal of vascular and endovascular surgery</jtitle><addtitle>Eur J Vasc Endovasc Surg</addtitle><date>2016-11-01</date><risdate>2016</risdate><volume>52</volume><issue>5</issue><spage>650</spage><epage>656</epage><pages>650-656</pages><issn>1078-5884</issn><eissn>1532-2165</eissn><abstract>Objective Near-infrared spectroscopy (NIRS) non-invasively determines tissue oxygen saturation (St o2 ) in muscle tissue. Its application to monitor real time hemodynamic changes during percutaneous transluminal angioplasty (PTA) and St o2 changes in feet 4 weeks after PTA was evaluated. Methods This study included 14 patients with critical limb ischemia (CLI, six patients Rutherford classification Stage IV, two patients Stage V, and six patients Stage VI). In patients with arterial ulcers, NIRS optodes were placed near the ulcer of the diseased foot (Optode 1), and at the same spot at the contralateral foot (Optode 2). In patients without arterial ulcers, Optode 1 was placed on the dorsum of the diseased foot, and Optode 2 was placed on the dorsum of the contralateral foot. Single St o2 values, ankle brachial indices, and toe brachial indices were obtained at rest before the start of endovascular revascularization and 4 weeks after treatment. During the endovascular procedure, continuous St o2 measurements were recorded throughout the intervention. Completion angiograms were used to evaluate the success of intervention. Results Patients underwent treatment of the superficial femoral artery (79%), popliteal artery (21%), and below the knee arteries (43%). In 13 of the 14 patients, completion angiograms showed successful treatment of target lesions. Ankle brachial indices and toe brachial indices significantly increased 4 weeks after treatment (both p  &lt; .01). Single St o2 values of Optode 1 also significantly increased four weeks after treatment ( p  &lt; .01). In contrast, single St o2 values of Optode 2 did not ( p  = .73). During the endovascular procedure, continuous St o2 measurements of Optode 1 and 2 did not increase ( p  = .80, and p  = .61, respectively). Conclusions NIRS monitoring of foot oxygenation in patients undergoing endovascular revascularization is safe and feasible. NIRS is a promising non-invasive technique to monitor hemodynamic changes in the feet of CLI patients after endovascular treatment using single St o2 values.</abstract><cop>England</cop><pub>Elsevier Ltd</pub><pmid>27614555</pmid><doi>10.1016/j.ejvs.2016.07.020</doi><tpages>7</tpages><orcidid>https://orcid.org/0000-0003-3614-9168</orcidid><oa>free_for_read</oa></addata></record>
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subjects Angioplasty
Lower extremity
Muscles
Near-infrared spectroscopy
Peripheral arterial disease
Surgery
title Monitoring of Foot Oxygenation with Near-infrared Spectroscopy in Patients with Critical Limb Ischemia Undergoing Percutaneous Transluminal Angioplasty: A Pilot Study
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