Impact of Peripheral Angioplasty on Wound Oxygenation and Healing in Patients with Chronic Limb-Threatening Ischemia Measured by Near-Infrared Spectroscopy

Overview

Journal Biomedicines

Specialty Biomedical Engineering

Date 2024 Aug 29

PMID 39200269

Authors

Johanna Schremmer

Manuel Stern

Sven Baasen

Patricia Wischmann

Ramy Foerster

Miriam Schillings

Kalman Bodis

Roberto Sansone

Christian Heiss

Malte Kelm

Lucas Busch

Affiliations

Soon will be listed here.

Abstract

Managing chronic limb-threatening ischemia (CLTI) is challenging due to difficulties in assessing tissue oxygen saturation in ulcers. Near-infrared spectroscopy (NIRS) is a non-invasive method for measuring tissue oxygen saturation (StO). This study evaluated the effects of endovascular treatment (EVT) on StO and wound healing in CLTI patients, comparing NIRS to standard ankle-brachial index (ABI) measurements. Using the Duesseldorf PTA Registry, 43 CLTI patients were analyzed: 27 underwent EVT, and 16 received conservative treatment. ABI assessed macrocirculation, while NIRS measured wound, wound area, and mean foot StO at baseline, post-EVT, and four-month follow-up. Wound severity was classified by wound area and wound, ischemia, and foot infection (WIfI) score. Wound StO increased significantly (median (interquartile range (IQR)), 38 (49.3) to 60 (34.5)%, = 0.004), as did wound area StO (median (IQR), 70.9 (21.6) to 72.8 (18.3)%, < 0.001), with no significant changes in the control group by four-month follow-up. Wound area decreased significantly after EVT (mean ± SD, 343.1 ± 267.8 to 178.1 ± 268.5 mm, = 0.01) but not in the control group. Changes in wound StO, wound area StO, and WIfI score correlated with wound area reduction, unlike ABI. This small exploratory study shows that NIRS-measured StO improvements after EVT correlate with reduced wound area and WIfI scores, highlighting NIRS as a potential enhancement for CLTI wound management in addition to ABI.

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