Development of a Non-Invasive Local Heating Load Test to Detect Severe Limb Ischemia Within 200 seconds

Development of a Non-Invasive Local Heating Load Test to Detect Severe Limb Ischemia Within 200 seconds

Purpose To establish a non-invasive test method for the rapid detection of severe ischemia (SI) in the limbs in patients with peripheral arterial disease (PAD). Methods Between November 2019 and May 2021, 22 patients admitted for PAD to 2 hospitals agreed to participate in the study. All patients un...

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Veröffentlicht in:Vascular and endovascular surgery 2023-01, Vol.57 (1), p.19-25
Hauptverfasser: Katsui, Sotaro, Yamamoto, Yohei, Kudo, Toshifumi
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creator Katsui, Sotaro
Yamamoto, Yohei
Kudo, Toshifumi
description Purpose To establish a non-invasive test method for the rapid detection of severe ischemia (SI) in the limbs in patients with peripheral arterial disease (PAD). Methods Between November 2019 and May 2021, 22 patients admitted for PAD to 2 hospitals agreed to participate in the study. All patients underwent a local heating load (LHL) test. SI was defined as at least 1 ankle-brachial index value of
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Methods Between November 2019 and May 2021, 22 patients admitted for PAD to 2 hospitals agreed to participate in the study. All patients underwent a local heating load (LHL) test. SI was defined as at least 1 ankle-brachial index value of &lt;.4 and/or transcutaneous oximetry value of &lt;30 mmHg. The other cases were classified as mild-to-moderate ischemia (MMI). The LHL test was performed simultaneously with 15 minutes of heating and measurement by attaching a blood flow meter measuring probe combined with a warmer to the patient’s dorsal foot. Evaluation consisted of 200-s periods from the start of heating to 800 seconds. For each period, perfusion value (PV) was evaluated, and slope was calculated graphically based on linear regression as PV fluctuation per minute. Test accuracy was calculated using a receiver operating characteristic curve. Results Twenty-four limbs of 18 patients were finally evaluated; 4 patients (2 with missing data, 1 with collagen disease, and 1 with embolism) were excluded, with 13 and 11 limbs in the SI and MMI groups, respectively. The SI group showed a significantly lower slope value in the first 200 seconds and lower PV at 200 seconds and thereafter. From the slope value, it was possible to detect SI with 85% sensitivity and 73% specificity at 200 seconds. PV could be determined with higher accuracy in periods after 200 seconds, with 85% sensitivity and 82% specificity at 800 seconds. Conclusions Our non-invasive LHL test could be used as a rapid screening test to detect SI in limbs within 200 seconds, as well as a more accurate test to detect ischemia within 800 seconds.</description><identifier>ISSN: 1538-5744</identifier><identifier>EISSN: 1938-9116</identifier><identifier>DOI: 10.1177/15385744221120977</identifier><identifier>PMID: 35968758</identifier><language>eng</language><publisher>Los Angeles, CA: SAGE Publications</publisher><subject>Original</subject><ispartof>Vascular and endovascular surgery, 2023-01, Vol.57 (1), p.19-25</ispartof><rights>The Author(s) 2022</rights><rights>The Author(s) 2022 2022 SAGE Publications</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c297t-ab70a1c72683a11b81c0ce789e4298196c31f5fb5338b3c2a97d77a5d5018d1f3</cites><orcidid>0000-0002-2845-6734</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://journals.sagepub.com/doi/pdf/10.1177/15385744221120977$$EPDF$$P50$$Gsage$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://journals.sagepub.com/doi/10.1177/15385744221120977$$EHTML$$P50$$Gsage$$Hfree_for_read</linktohtml><link.rule.ids>230,314,776,780,881,21798,27901,27902,43597,43598</link.rule.ids></links><search><creatorcontrib>Katsui, Sotaro</creatorcontrib><creatorcontrib>Yamamoto, Yohei</creatorcontrib><creatorcontrib>Kudo, Toshifumi</creatorcontrib><title>Development of a Non-Invasive Local Heating Load Test to Detect Severe Limb Ischemia Within 200 seconds</title><title>Vascular and endovascular surgery</title><addtitle>Vasc Endovascular Surg</addtitle><description>Purpose To establish a non-invasive test method for the rapid detection of severe ischemia (SI) in the limbs in patients with peripheral arterial disease (PAD). Methods Between November 2019 and May 2021, 22 patients admitted for PAD to 2 hospitals agreed to participate in the study. All patients underwent a local heating load (LHL) test. SI was defined as at least 1 ankle-brachial index value of &lt;.4 and/or transcutaneous oximetry value of &lt;30 mmHg. The other cases were classified as mild-to-moderate ischemia (MMI). The LHL test was performed simultaneously with 15 minutes of heating and measurement by attaching a blood flow meter measuring probe combined with a warmer to the patient’s dorsal foot. Evaluation consisted of 200-s periods from the start of heating to 800 seconds. For each period, perfusion value (PV) was evaluated, and slope was calculated graphically based on linear regression as PV fluctuation per minute. Test accuracy was calculated using a receiver operating characteristic curve. Results Twenty-four limbs of 18 patients were finally evaluated; 4 patients (2 with missing data, 1 with collagen disease, and 1 with embolism) were excluded, with 13 and 11 limbs in the SI and MMI groups, respectively. The SI group showed a significantly lower slope value in the first 200 seconds and lower PV at 200 seconds and thereafter. From the slope value, it was possible to detect SI with 85% sensitivity and 73% specificity at 200 seconds. PV could be determined with higher accuracy in periods after 200 seconds, with 85% sensitivity and 82% specificity at 800 seconds. Conclusions Our non-invasive LHL test could be used as a rapid screening test to detect SI in limbs within 200 seconds, as well as a more accurate test to detect ischemia within 800 seconds.</description><subject>Original</subject><issn>1538-5744</issn><issn>1938-9116</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2023</creationdate><recordtype>article</recordtype><sourceid>AFRWT</sourceid><recordid>eNp9Uc1q3DAQFiWhSdM-QG869uJUI1mWdCmU_C4szSEJPQpZHu8q2NLG8i7kbfIsebIqbCiUQk4zw_czfDOEfAV2CqDUd5BCS1XXnANwZpT6QI7BCF0ZgOag9AWvXglH5FPOD4yBhlp_JEdCmkYrqY_J-hx3OKTNiHGmqaeO_kqxWsSdy2GHdJm8G-g1ujnEVZlcR-8wz3RO9Bxn9DO9LfqpEMPY0kX2axyDo7_DvA6RcsZenjP6FLv8mRz2bsj45a2ekPvLi7uz62p5c7U4-7msPDdqrlyrmAOveKOFA2g1eOZRaYM1NxpM4wX0sm-lELoVnjujOqWc7GQJ10EvTsiPve9m247Y-ZJrcoPdTGF005NNLth_kRjWdpV21jTKKNMUg29vBlN63JawdgzZ4zC4iGmbLVeM11pyEIUKe6qfUs4T9n_XALOvH7L_fahoTvea7FZoH9J2iuUc7wj-AIbVj4o</recordid><startdate>20230101</startdate><enddate>20230101</enddate><creator>Katsui, Sotaro</creator><creator>Yamamoto, Yohei</creator><creator>Kudo, Toshifumi</creator><general>SAGE Publications</general><scope>AFRWT</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><scope>5PM</scope><orcidid>https://orcid.org/0000-0002-2845-6734</orcidid></search><sort><creationdate>20230101</creationdate><title>Development of a Non-Invasive Local Heating Load Test to Detect Severe Limb Ischemia Within 200 seconds</title><author>Katsui, Sotaro ; Yamamoto, Yohei ; Kudo, Toshifumi</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c297t-ab70a1c72683a11b81c0ce789e4298196c31f5fb5338b3c2a97d77a5d5018d1f3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2023</creationdate><topic>Original</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Katsui, Sotaro</creatorcontrib><creatorcontrib>Yamamoto, Yohei</creatorcontrib><creatorcontrib>Kudo, Toshifumi</creatorcontrib><collection>Sage Journals GOLD Open Access 2024</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Vascular and endovascular surgery</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Katsui, Sotaro</au><au>Yamamoto, Yohei</au><au>Kudo, Toshifumi</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Development of a Non-Invasive Local Heating Load Test to Detect Severe Limb Ischemia Within 200 seconds</atitle><jtitle>Vascular and endovascular surgery</jtitle><addtitle>Vasc Endovascular Surg</addtitle><date>2023-01-01</date><risdate>2023</risdate><volume>57</volume><issue>1</issue><spage>19</spage><epage>25</epage><pages>19-25</pages><issn>1538-5744</issn><eissn>1938-9116</eissn><abstract>Purpose To establish a non-invasive test method for the rapid detection of severe ischemia (SI) in the limbs in patients with peripheral arterial disease (PAD). Methods Between November 2019 and May 2021, 22 patients admitted for PAD to 2 hospitals agreed to participate in the study. All patients underwent a local heating load (LHL) test. SI was defined as at least 1 ankle-brachial index value of &lt;.4 and/or transcutaneous oximetry value of &lt;30 mmHg. The other cases were classified as mild-to-moderate ischemia (MMI). The LHL test was performed simultaneously with 15 minutes of heating and measurement by attaching a blood flow meter measuring probe combined with a warmer to the patient’s dorsal foot. Evaluation consisted of 200-s periods from the start of heating to 800 seconds. For each period, perfusion value (PV) was evaluated, and slope was calculated graphically based on linear regression as PV fluctuation per minute. Test accuracy was calculated using a receiver operating characteristic curve. Results Twenty-four limbs of 18 patients were finally evaluated; 4 patients (2 with missing data, 1 with collagen disease, and 1 with embolism) were excluded, with 13 and 11 limbs in the SI and MMI groups, respectively. The SI group showed a significantly lower slope value in the first 200 seconds and lower PV at 200 seconds and thereafter. From the slope value, it was possible to detect SI with 85% sensitivity and 73% specificity at 200 seconds. PV could be determined with higher accuracy in periods after 200 seconds, with 85% sensitivity and 82% specificity at 800 seconds. Conclusions Our non-invasive LHL test could be used as a rapid screening test to detect SI in limbs within 200 seconds, as well as a more accurate test to detect ischemia within 800 seconds.</abstract><cop>Los Angeles, CA</cop><pub>SAGE Publications</pub><pmid>35968758</pmid><doi>10.1177/15385744221120977</doi><tpages>7</tpages><orcidid>https://orcid.org/0000-0002-2845-6734</orcidid><oa>free_for_read</oa></addata></record>
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title Development of a Non-Invasive Local Heating Load Test to Detect Severe Limb Ischemia Within 200 seconds
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