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Newer Techniques for Assessment of Foot Perfusion

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Limb Salvage of the Diabetic Foot

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Abstract

There has been significant progress in limb salvage in patients with peripheral arterial disease (PAD) and critical limb ischemia (CLI) over the past 2 decades. These advancements have been promoted by the increased knowledge and understanding of the disease processes as well as the refinement in the interventions and enhanced patient care after revascularization. Digital subtraction angiography (DSA) remains the gold standard for visualizing the atherosclerotic lesions but it is slowly being supplanted in clinical practice by noninvasive imaging standards—such as computed tomographic angiography (CTA) and magnetic resonance angiography (MRA). Newer technology is now emerging as vascular specialists shift their focus from a macro limb perspective to a more regional foot perspective. Among the current and emerging regional perfusion imaging modalities are transcutaneous oximetry, laser Doppler flowmetry (LDF), hyperspectral imaging (HSI), indocyanine green (ICG) dye-based fluorescent angiography, and nuclear diagnostic imaging. These tests attempt to delineate regional foot perfusion for guiding directed revascularization therapy of PAD/CLI.

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Author information

Authors and Affiliations

  1. Department of Vascular Surgery, Massachusetts General Hospital, Boston, MA, USA

    Brandon J. Sumpio

  2. Department of Surgery, Yale University School of Medicine, New Haven, CT, USA

    Samuel M. Miller

  3. Department of Surgery (Vascular), Yale University School of Medicine, New Haven, CT, USA

    Erik Benitez & Bauer E. Sumpio

Authors
  1. Brandon J. Sumpio
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  2. Samuel M. Miller
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  3. Erik Benitez
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  4. Bauer E. Sumpio
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Correspondence to Bauer E. Sumpio .

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Editors and Affiliations

  1. King’s College Hospital, London, UK

    Michael E. Edmonds

  2. School of Medicine, Yale University, New Haven, CT, USA

    Bauer E. Sumpio

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Sumpio, B.J., Miller, S.M., Benitez, E., Sumpio, B.E. (2019). Newer Techniques for Assessment of Foot Perfusion. In: Edmonds, M., Sumpio, B. (eds) Limb Salvage of the Diabetic Foot. Springer, Cham. https://doi.org/10.1007/978-3-319-17918-6_20

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  • DOI: https://doi.org/10.1007/978-3-319-17918-6_20

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-17917-9

  • Online ISBN: 978-3-319-17918-6

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