Intraoperative evaluation of revascularization effect on ischemic muscle hemodynamics using near-infrared diffuse optical spectroscopies

Abstract

Abstract. Arterial revascularization in patients with peripheral arterial disease (PAD) reestablishes large arterial blood supply to the ischemic muscles in lower extremities via bypass grafts or percutaneous transluminal angioplasty (PTA). Currently no gold standard is available for assessment of revascularization effects in lower extremity muscles. This study tests a novel near-infrared diffuse correlation spectroscopy flow-oximeter for monitoring of blood flow and oxygenation changes in medial gastrocnemius (calf) muscles during arterial revascularization. Twelve limbs with PAD undergoing revascularization were measured using a sterilized fiber-optic probe taped on top of the calf muscle. The optical measurement demonstrated sensitivity to dynamic physiological events, such as arterial clamping/releasing during bypass graft and balloon inflation/deflation during PTA. Significant elevations in calf muscle blood flow were observed after revascularization in patients with bypass graft ( + 48.1 ± 17.5%) and patients with PTA ( + 43.2 ± 11.0%), whereas acute post-revascularization effects in muscle oxygenation were not evident. The decoupling of flow and oxygenation after revascularization emphasizes the need for simultaneous measurement of both parameters. The acute elevations/improvements in calf muscle blood flow were associated with significant improvements in symptoms and functions. In total, the investigation corroborates potential of the optical methods for objectively assessing the success of arterial revascularization. C 2011 Society of Photo-Optical Instrumentation Engineers (SPIE).

Clinical applications of near-infrared diffuse correlation spectroscopy and tomography for tissue blood flow monitoring and imaging

“…3) and DCT (Fig. 4) measurements in different applications (Huang et al , 2015c; Durduran et al , 2005; Yu et al , 2011; Shang et al , 2011b; Huang et al , 2015b) (see Section 3 ). These probes are connected to the DCS/DCT instruments (Fig.…”

“…A few studies have been reported using DCS to investigate the impacts of surgical interventions on skeletal muscle diseases (Yu et al , 2011; Huang et al , 2015c). For muscular revascularization, ultrasound Doppler is routinely used in surgical rooms to test post-surgical reperfusion in large vessels.…”

Near-infrared diffuse correlation spectroscopy in cancer diagnosis and therapy monitoring

“…[25][26][27] DCS can be easily and continually applied at the bedside in clinical rooms. [28][29][30][31][32][33][34] 35 and has been used less in the "cancer" context than in other scenarios such as brain and muscle. Therefore, a review of potential for cancer applications of DCS is valuable at this time for both optical and cancer communities.…”

Mapping breast cancer blood flow index, composition, and metabolism in a human subject using combined diffuse optical spectroscopic imaging and diffuse correlation spectroscopy

“…[8][9][10] The blood flow index (BFI) measured by DCS has been validated by arterial spin-labeled magnetic resonance imaging, 11 Doppler ultrasound, 12,13 Xenon computed tomography, 14 and laser Doppler flowmetry. 15,16 Further, DCS systems have been used to monitor blood flow changes in clinical applications associated with brain, 13,14,17 skeletal muscle, 11,18,19 and tumors. 10,[20][21][22][23] When taken together, DCS and DOSI can provide a noninvasive measurement of the metabolic rate of oxygen consumption in tissue, and indeed, several studies have shown that the combination of DOSI and DCS techniques in breast lesion characterization provides a better understanding of tumor physiology and metabolism and may enhance treatment monitoring in the presurgical setting.…”