Assessment of revascularization impact on microvascular oxygenation and perfusion using spatial frequency domain imaging.
Ikeoluwapo Kendra Bolakale-RufaiMallory R ThompsonKirsten Concha-MooreSamuel JettShubhangi AwasthiDavid J CucciaAmaan MazharCraig C WeinkaufPublished in: Journal of surgical case reports (2023)
The microvasculature (with vessels <100 μm in diameter) plays a crucial role in tissue oxygenation, perfusion and wound healing in the lower limb. While this holds clinical significance, microvasculature evaluation in the limbs is not a standard practice. Surgical interventions focus on reestablishing blood flow in larger vessels affected by the peripheral artery disease (PAD). Nevertheless, the impact of revascularization on tissue oxygenation and perfusion in severe microvascular disease (MVD) is still unknown. We present the cases of two patients who underwent surgical revascularization for peripheral blood flow with different outcomes. Patient A had PAD, while B had PAD, severe MVD and a non-healing wound. Although both showed improvements in ankle-brachial index post-op, spatial frequency domain imaging metrics (which measure microvascular oxygenation and perfusion) remained unchanged in B, indicating a potential gap in assessing the surgical efficacy in MVD using ankle brachial index and emphasizing microcirculation evaluation in optimizing wound healing outcomes.
Keyphrases
- blood flow
- wound healing
- peripheral artery disease
- lower limb
- contrast enhanced
- percutaneous coronary intervention
- coronary artery bypass grafting
- high resolution
- end stage renal disease
- ejection fraction
- newly diagnosed
- chronic kidney disease
- early onset
- healthcare
- magnetic resonance imaging
- computed tomography
- coronary artery disease
- magnetic resonance
- risk assessment
- acute coronary syndrome
- quality improvement
- adipose tissue
- atrial fibrillation
- climate change
- patient reported outcomes
- optical coherence tomography