A Pilot Study Investigating the Use of Regional Oxygen Saturation as a Predictor of Ischemic Wound Healing Outcome after Endovascular Treatment in Patients with Chronic Limb-Threatening Ischemia

Kayama, Takafumi; Sano, Masaki; Inuzuka, Kazunori; Katahashi, Kazuto; Yata, Tatsuro; Yamanaka, Yutaka; Naruse, Ena; Yamamoto, Naoto; Takeuchi, Hiroya; Unno, Naoki

doi:10.3400/avd.oa.20-00132

Cited by 9 publications

(13 citation statements)

References 26 publications

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“…A previous study identified that an rSO 2 of more than 50% may be a cut-off value for wound healing. 28 ) Patient cardiac function, physique, and skin color do not influence the rSO 2 value. Therefore, TOE-20 may become an ideal diagnostic device to monitor tissue perfusion/oxygenation in real-time.…”

Section: Discussionmentioning

confidence: 91%

The Patency of Tibial/Peroneal Arteries Affects the Increment of Regional Tissue Saturation of Oxygen in Each Angiosome after Superficial Femoral Artery Revascularization

Unno

Inuzuka

Yamamoto

et al. 2022

Annals of Vascular Diseases

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Objective: The angiosome model is a controversial concept in the revascularization of patients with chronic limbthreatening ischemia (CLTI). The aim of this study was to demonstrate the importance of patency of the tibial/peroneal arteries for regional tissue oxygenation in each angiosome during endovascular therapy (EVT) of the superficial femoral artery (SFA). Materials and Methods:We devised a novel near-infrared spectroscopy oximeter, "TOE-20," for real-time monitoring of regional tissue oxygen saturation (rSO 2 ). Using TOE-20, we prospectively assessed rSO 2 at each angiosome in 23 CLTI patients who underwent successful revascularization of the SFA. During EVT, three sensor probes were placed at the dorsal foot, plantar foot, and outer ankle for rSO 2 monitoring. Results: At the end of EVT, rSO 2 at all angiosomes was significantly elevated by SFA revascularization. The change in rSO 2 in each angiosome was larger in patients with patent relevant arteries than in those with occluded relevant arteries (i.e., anterior tibial artery patency, posterior tibial artery patency, and peroneal artery patency). Conclusion:The patency of the tibial/peroneal arteries is important for regional tissue oxygenation in EVT. Using TOE-20 and rSO 2 -based revascularization, it may possible to anticipate whether an ischemic ulcer will heal or not.

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Section: Discussionmentioning

confidence: 91%

The Patency of Tibial/Peroneal Arteries Affects the Increment of Regional Tissue Saturation of Oxygen in Each Angiosome after Superficial Femoral Artery Revascularization

Unno

Inuzuka

Yamamoto

et al. 2022

Annals of Vascular Diseases

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“…All patients with an rSO 2 of ≥50% in the dorsal foot on postoperative day 1 exhibited improved ulcer healing, indicating that an rSO 2 of ≥50% might be a cutoff value for wound healing. 8 Further studies with longer observation periods are required to verify the cutoff value of rSO 2 for wound healing.…”

Section: Discussionmentioning

confidence: 99%

Real-time assessment of tissue oxygen saturation during endovascular therapy for chronic limb threatening ischemia using a novel oximeter

Unno

Inuzuka

Sano

et al. 2022

Journal of Vascular Surgery Cases, Innovations and Techniques

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This is a PDF file of an article that has undergone enhancements after acceptance, such as the addition of a cover page and metadata, and formatting for readability, but it is not yet the definitive version of record. This version will undergo additional copyediting, typesetting and review before it is published in its final form, but we are providing this version to give early visibility of the article. Please note that, during the production process, errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain.

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“…A finger-worn tissue oximeter that uses NIRS technology has been developed (Toccare: Astem Co., Ltd., Kawasaki, Japan) to measure rSO 2 values to depths of 0–5 mm below the skin surface. According to several research reports, NIRS enables a painless and simple measurement of rSO 2 in any area of the foot and reflects microcirculation [ 37 , 38 , 39 ]. While these advantages are similar to those of SMI, NIRS is difficult to quantify; SMI is superior to NIRS for the quantitative assessment of foot microcirculation.…”

Section: Discussionmentioning

confidence: 99%

Utility of Superb Microvascular Imaging in the Assessment of Foot Perfusion in Patients with Critical Limb Ischemia

et al. 2022

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(1) Background: Although the ankle–brachial index (ABI) and skin perfusion pressure (SPP) are commonly used to evaluate the peripheral circulation in critical limb ischemia (CLI), they often cannot be performed on sore areas. We investigated the utility of superb microvascular imaging (SMI) for assessing foot perfusion in CLI patients. (2) Methods: We measured the SMI-based vascular index (SMI-VI) at six sites in the foot before and after endovascular treatment (EVT) in 50 patients with CLI who underwent EVT of the superficial femoral artery and compared the results with SPP values and the ABI. (3) Results: SMI visualized foot perfusion in all subjects in accordance with the angiosome, including the toe areas, while the ABI was unmeasurable in three patients on hemodialysis and SPP failed in four patients. SMI-VI values were significantly lower in the CLI group than in controls, and the plantar SMI-VI had the highest diagnostic performance for CLI (sensitivity 88.6%, specificity 95.6%). After EVT, the increase in the SMI-VI was positively correlated with the increase in SPP but not that in the ABI, implying that the SMI-VI reflects foot microcirculation. (4) Conclusions: SMI enables the visualization and quantification of foot microcirculation based on the angiosome. SMI has high utility as a tool for assessing foot perfusion in CLI.

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A Pilot Study Investigating the Use of Regional Oxygen Saturation as a Predictor of Ischemic Wound Healing Outcome after Endovascular Treatment in Patients with Chronic Limb-Threatening Ischemia

Cited by 9 publications

References 26 publications

The Patency of Tibial/Peroneal Arteries Affects the Increment of Regional Tissue Saturation of Oxygen in Each Angiosome after Superficial Femoral Artery Revascularization

The Patency of Tibial/Peroneal Arteries Affects the Increment of Regional Tissue Saturation of Oxygen in Each Angiosome after Superficial Femoral Artery Revascularization

Real-time assessment of tissue oxygen saturation during endovascular therapy for chronic limb threatening ischemia using a novel oximeter

Utility of Superb Microvascular Imaging in the Assessment of Foot Perfusion in Patients with Critical Limb Ischemia

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