Comprehensive imaging of microcirculatory changes in the foot during endovascular intervention - A technical feasibility study

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Hultman, Martin,1992-Linköpings universitet,Avdelningen för medicinsk teknik,Tekniska fakulteten (author)

Comprehensive imaging of microcirculatory changes in the foot during endovascular intervention - A technical feasibility study

Article/chapterEnglish2022

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Maryland Heights, MO, United States :Academic Press,2022
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LIBRIS-ID:oai:DiVA.org:liu-182544
https://urn.kb.se/resolve?urn=urn:nbn:se:liu:diva-182544URI
https://doi.org/10.1016/j.mvr.2022.104317DOI

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Language:English
Summary in:English

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Subject category:art swepub-publicationtype

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Funding: Swedish Research CouncilSwedish Research CouncilEuropean Commission [2014-6141]; Swedens Innovation Agency VINNOVAVinnova [2017-01435, 2019-01522]
Chronic limb-threatening ischemia (CLTI) has a major impact on patient's lives and is associated with a heavy health care burden with high morbidity and mortality. Treatment by endovascular intervention is mostly based on macrocirculatory information from angiography and does not consider the microcirculation. Despite successful endovascular intervention according to angiographic criteria, a proportion of patients fail to heal ischemic lesions. This might be due to impaired microvascular perfusion and variations in the supply to different angiosomes. Non-invasive optical techniques for microcirculatory perfusion and oxygen saturation imaging have the potential to provide the interventionist with additional information in real-time, supporting clinical decisions during the intervention. This study presents a novel multimodal imaging system, based on multi-exposure laser speckle contrast imaging and multi-spectral imaging, for continuous use during endovascular intervention. The results during intervention display spatiotemporal changes in the microcirculation compatible with expected physiological reactions during balloon dilation, with initially induced ischemia followed by a restored perfusion, and local administration of a vasodilator inducing hyperemia. We also present perioperative and postoperative follow-up measurements with a pulsatile microcirculation perfusion. Finally, cases of spatial heterogeneity in the observed oxygen saturation and perfusion are discussed. In conclusion, this technical feasibility study shows the potential of the methodology to characterize changes in microcirculation before, during, and after endovascular intervention.

Subject headings and genre

MEDICIN OCH HÄLSOVETENSKAP Klinisk medicin Anestesi och intensivvård hsv//swe
MEDICAL AND HEALTH SCIENCES Clinical Medicine Anesthesiology and Intensive Care hsv//eng
Chronic limb-threatening ischemia
Microcirculation
Multi-exposure laser speckle contrast imaging
Multi-spectral imaging

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Aronsson, SofieLinköpings universitet,Avdelningen för diagnostik och specialistmedicin,Medicinska fakulteten(Swepub:liu)n/a (author)
Fredriksson, Ingemar,1980-Linköpings universitet,Avdelningen för medicinsk teknik,Tekniska fakulteten,Perimed AB, Järfälla, Stockholm, Sweden(Swepub:liu)ingfr98 (author)
Zachrisson, Helene,1964-Linköpings universitet,Avdelningen för diagnostik och specialistmedicin,Medicinska fakulteten,Region Östergötland, Fysiologiska kliniken US(Swepub:liu)helza09 (author)
Pärsson, Håkan N.Linköpings universitet,Avdelningen för kirurgi, ortopedi och onkologi,Medicinska fakulteten(Swepub:liu)hakpa77 (author)
Larsson, Marcus,1974-Linköpings universitet,Avdelningen för medicinsk teknik,Tekniska fakulteten(Swepub:liu)marla29 (author)
Strömberg, Tomas,1966-Linköpings universitet,Avdelningen för medicinsk teknik,Tekniska fakulteten(Swepub:liu)tomst50 (author)
Linköpings universitetAvdelningen för medicinsk teknik (creator_code:org_t)

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In:Microvascular ResearchMaryland Heights, MO, United States : Academic Press1410026-28621095-9319

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