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Laser doppler flowmetry in lower extremity ischemia: Application and interpretation

  • Original Articles
  • Published:
Annals of Vascular Surgery

Abstract

The present study was undertaken in order to develop numerical criteria for the parameters of laser Doppler flowmetry-skin blood flow velocity and pulse wave amplitude in the evaluation of lower extremity ischemia. Fifty limbs of young healthy volunteers were examined in order to obtain baseline normal values. Patient population was divided into moderately ischemic (52 limbs) and severely ischemic (22 limbs), based on patients' complaints, physical examination, ankle-brachial indices, pulse volume recordings and arteriographies. Univariate comparison between the three groups of skin blood flow velocity and pulse wave amplitude at each time point were done by analysis of variance. Power of discrimination between degrees of ischemia was evaluated by computing sensitivity and specificity, based on skin blood flow velocity and pulse wave amplitude values at time points best for predicting the severity of disease by multiple regression analysis. Using cutoff points of <31 for skin blood flow velocity and <9 for pulse wave amplitude, a 96% sensitivity and 96% specificity were obtained in separating normal from ischemic limbs. Cutoff points of <9 for skin blood flow velocity and <4 for pulse wave amplitude discriminated with a 100% sensitivity and specificity between the moderately and severely ischemic limbs. We propose the use of laser Doppler flowmetry with local heating and reactive hyperemia, and the cutoff points stated above as an additional tool to evaluate lower extremity ischemia through assessment of cutaneous microcirculation.

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References

  1. WALDEN R, MODAN M, BASS A, et al. Scoring of vascular disease in the lower extremities.J Cardiovasc Surg 1989;30:210–215.

    Google Scholar 

  2. HOLLOWAY G, WATKINS W. Laser Doppler measurement of cutaneous blood flow.J Invest Dermatol 1977;69:306–309.

    PubMed  Google Scholar 

  3. NILSSON GE, TENLAND T, OBERG PA. Evaluation of laser Doppler flowmetry for measurement of tissue blood flow.IEEE Trans Biomed Eng 1980;BME-27:597–604.

    Google Scholar 

  4. MATSEN FA, WYSS CR, ROBERTSON CL, et al. The relationship of PO2 and laser Doppler measurements in a human model of arterial insufficiency.Surg Gynecol Obstet 1984;159:418–422.

    PubMed  Google Scholar 

  5. ROSENBERG L, MOLCHO J, DOTAN Y, et al. Use of the Doppler effect in visible light to assess tissue viability by capillary blood flow.Ann Plastic Surg 1982;8(3:206–212.

    Google Scholar 

  6. KARANFILIAN RG, LYNCH TG, LEE BC, et al. The assessment of skin blood flow in peripheral vascular disease by laser Doppler velocimetry.Am Surg 1984;50:641–644.

    PubMed  Google Scholar 

  7. KVERNEBO K, SLAGSVOLD CE, STRANDEN E, et al. Laser Doppler flowmetry in evaluation of lower limb resting skin circulation. A study in healthy controls and atherosclerotic patients.Scand J Clin Lab Invest 1988;48:621–626.

    PubMed  Google Scholar 

  8. WINSOR T, HAUMSCHILD DJ, WINSOR DW, et al. Clinical application of laser Doppler flowmetry for measurement of cutaneous circulation in health and disease.Angiology 1987;38:727–736.

    PubMed  Google Scholar 

  9. LEONARDO G, ARPAIA MR, DEL GUERCIO R. A new method for the quantitative assessment of arterial insufficiency of the limbs: cutaneous postischemic test by laser Doppler.Angiology 1987;37:378–385.

    Google Scholar 

  10. PABST TS, CASTRONUOVO JJ, JACKSON SD, et al. Evaluation of the ischemic limb by pressure and flow measurement of the skin microcirculation as determined by laser Doppler velocimetry.Curr Surg 1985;42:29–31.

    PubMed  Google Scholar 

  11. STERN MD, LAPPE DL, BOWEN PD. Continuous measurement of tissue blood flow in laser Doppler spectroscopy.Am J Physiol 1977;323:H441-H448.

    Google Scholar 

  12. LERCHE A. PAASKE WP. Laser Doppler examination of peripheral microvascular reactivity.Surg Gynecol Obstet 163:410–414.

  13. KARANFILIAN RG, LYNCH TG, ZIROL VT, et al. The value of laser Doppler velocimetry and transcutaneous oxygen tension determination in predicting healing of ischemic forefoot ulcerations and amputations in diabetic and nondiabetic patients.J Vasc Surg 1986;4:511–516.

    PubMed  Google Scholar 

  14. FAIRS SLE, HAM RO, CONWAY BA, et al. Limb perfusion in the lower limb amputee: a comparative study using a laser Doppler flowmeter and a transcutaneous oxygen method.Prosth Ortho Int 1987;11:80–84.

    Google Scholar 

  15. WAXMAN K, FORMOSA P, SOLIMAN H, et al. Laser Doppler velocimetry in critically ill patients.Crit Care Med 1987;15:780–783.

    PubMed  Google Scholar 

  16. WYSS CR, MATSEN FA, KING RV. Dependence of trancutaneous oxygen tension of local arteriovenous pressure gradient in normal subjects.Clin Sci 1981;60:499–506.

    PubMed  Google Scholar 

  17. ENGELHART M, KRISTENSEN JK. Evaluation of cutaneous blood flow responses by 133-xenon washout and a laser Doppler flowmeter.J Invest Dermatol 1983;80:12–15.

    PubMed  Google Scholar 

  18. WILKIN JK. Periodic cutaneous blood flow during postocclusive reactive hyperemia.Am J Physiol 1986;250:H765-H768.

    PubMed  Google Scholar 

  19. WHITE RA, NOLAN R, HARLEY D, et al. Noninvasive evaluation of peripheral vascular disease using transcutaneous oxygen tension.Am J Surg 1982:144:68–75.

    PubMed  Google Scholar 

  20. FRANZECK UK, TALKE P, BERNSTEIN EF, et al. Transcutaneous PO2 measurements in health and peripheral arterial occlusive disease.Surgery 1982;91:156–163.

    PubMed  Google Scholar 

  21. HARWARD TR, VOLNEY J, GOLBRANSON F, et al. Oxygen inhalation-induced transcutaneous PO2 changes as predictor of amputation level.J Vasc Surg 1985;2:220–227.

    PubMed  Google Scholar 

  22. RHODES GR, SKUDDER P. Salvage of ischemic diabetic feet: role of transcutaneous oxygen mapping and multiple configurations of in situ bypass.Am J Surg 1986;152:165–171.

    PubMed  Google Scholar 

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Authors and Affiliations

  1. From the Lubinski Vascular Institute, the Department of General and Vascular Surgery, The Chaim Sheba Medical Center, the Tel-Aviv University Sackler Medical School, Tel-Hashomer, Israel

    Raphael Walden MD, Arie Bass MD, Moshe Balaciano MD, Michaela Modan PhD, Lea Zulty BSC & Raphael Adar MD

  2. the Department of Clinical Epidemiology, The Chaim Sheba Medical Center, The Tel-Aviv University Sackler Medical School, Tel-Hashomer, Israel

    Raphael Walden MD, Arie Bass MD, Moshe Balaciano MD, Michaela Modan PhD, Lea Zulty BSC & Raphael Adar MD

Authors
  1. Raphael Walden MD
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  2. Arie Bass MD
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  3. Moshe Balaciano MD
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  4. Michaela Modan PhD
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  5. Lea Zulty BSC
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  6. Raphael Adar MD
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Walden, R., Bass, A., Balaciano, M. et al. Laser doppler flowmetry in lower extremity ischemia: Application and interpretation. Annals of Vascular Surgery 6, 511–516 (1992). https://doi.org/10.1007/BF02000822

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