Near-Infrared Spectroscopy with a Provocative Maneuver to Detect the Presence of Severe Peripheral Arterial Disease
SnapshotNIR uses NIR (near-infrared) light to determine tissue oxygenation saturation (StO2) and hemoglobin levels, key indicators of tissue health. NIR wavelengths penetrate ~2-3mm into the tissue, making it ideal for microcirculation assessment in conditions like peripheral arterial disease.
Reiter, H.C.J. and Andersen, C.A., 2023. Near-Infrared Spectroscopy with a Provocative Maneuver to Detect the Presence of Severe Peripheral Arterial Disease. Journal of Vascular Surgery Cases, Innovations and Techniques, p.101379.
Publication in Journal of Vascular Surgery Cases, Innovations and Techniques
STUDY SUMMARY
Peripheral Arterial Disease (PAD) is often asymptomatic, and is under-diagnosed, under-recognized, and under-treated.
A true consensus is lacking on how to best screen for severe PAD and chronic limb-threatening ischemia (CLTI), highlighting the need for new diagnostic methods. Near-infrared spectroscopy (NIRS) might help fill this unmet need, because it provides a fast, non-invasive, and non-contact quantitative assessment of tissue oxygenation (StO2).
Elevate your standard of care with microcirculation assessments for patients with peripheral arterial disease.
Objective: The purpose of the investigation was to determine whether NIRS imaging during a provocative leg maneuver that affects limb perfusion could be used as an assessment tool to stratify patients by PAD severity and, specifically, to detect the presence of severe PAD or CLTI.
Methods: This retrospective observational cross-sectional study imaged 57 plantar foot surfaces in 34 patients in both the supine position and following a 60 second, 45o leg elevation. Patient limbs were stratified via clinical assessment into PAD severity groupings (normal, mild, moderate, severe).
The Provocative Leg Maneuver:
Begin with the patient lying supine
Take baseline SnapshotNIR images of the dorsal and plantar aspects of the foot
Elevate the leg to 45-degrees for 60 seconds
Re-image using SnapshotNIR on the dorsal and plantar aspects of the foot
Compare pre- and post-test tissue oxygenation (StO2) and hemoglobin levels (dexoyhemoglobin and oxyhemoglobin)
Results: SnapshotNIR can help differentiate your severe PAD patients in less than 2 minutes.
The change in StO2 with leg elevation was significantly greater in severe PAD compared to all other groups. The measures captured in supine did not show a difference.
Use this technique with your patients to support your clinical decision-making process.
These findings support using changes in oxygenation (StO2) instead of using single time points to assess patients and support NIRS as a tool to screen for severe PAD.
