scholarly journals Quantifying tissue perfusion after peripheral endovascular procedures: Novel tissue perfusion endpoints to improve outcomes

2021 ◽  
Vol 13 (9) ◽  
pp. 381-398
Author(s):  
Nikolaos-Achilleas Arkoudis ◽  
Konstantinos Katsanos ◽  
Riccardo Inchingolo ◽  
Ioannis Paraskevopoulos ◽  
Martin Mariappan ◽  
...  
Keyword(s):  
Endovascular Procedures ◽  
Tissue Perfusion

Initial experience with a new quantitative assessment tool for fluorescent imaging in peripheral artery disease

VASA ◽  
2017 ◽  
Vol 46 (5) ◽  
pp. 383-388 ◽  
Author(s):  
Henrik Christian Rieß ◽  
Anna Duprée ◽  
Christian-Alexander Behrendt ◽  
Tilo Kölbel ◽  
Eike Sebastian Debus ◽  
...  
Keyword(s):  
Indocyanine Green ◽  
Quantitative Assessment ◽  
Tissue Perfusion ◽  
Fluorescent Imaging ◽  
Peripheral Artery ◽  
Peripheral Bypass ◽  
Before And After ◽  
Artery Disease ◽  
Green Fluorescent ◽  
Peripheral Bypass Grafting

Abstract. Background: Perioperative evaluation in peripheral artery disease (PAD) by common vascular diagnostic tools is limited by open wounds, medial calcinosis or an altered collateral supply of the foot. Indocyanine green fluorescent imaging (ICG-FI) has recently been introduced as an alternative tool, but so far a standardized quantitative assessment of tissue perfusion in vascular surgery has not been performed for this purpose. The aim of this feasibility study was to investigate a new software for quantitative assessment of tissue perfusion in patients with PAD using indocyanine green fluorescent imaging (ICG-FI) before and after peripheral bypass grafting. Patients and methods: Indocyanine green fluorescent imaging was performed in seven patients using the SPY Elite system before and after peripheral bypass grafting for PAD (Rutherford III-VI). Visual and quantitative evaluation of tissue perfusion was assessed in an area of low perfusion (ALP) and high perfusion (AHP), each by three independent investigators. Data assessment was performed offline using a specially customized software package (Institute for Laser Technology, University Ulm, GmbH). Slope of fluorescent intensity (SFI) was measured as time-intensity curves. Values were compared to ankle-brachial index (ABI), slope of oscillation (SOO), and time to peak (TTP) obtained from photoplethysmography (PPG). Results: All measurements before and after surgery were successfully performed, showing that ABI, TTP, and SOO increased significantly compared to preoperative values, all being statistically significant (P < 0.05), except for TTP (p = 0.061). Further, SFI increased significantly in both ALP and AHP (P < 0.05) and correlated considerably with ABI, TTP, and SOO (P < 0.05). Conclusions: In addition to ABI and slope of oscillation (SOO), the ICG-FI technique allows visual assessment in combination with quantitative assessment of tissue perfusion in patients with PAD. Ratios related to different perfusion patterns and SFI seem to be useful tools to reduce factors disturbing ICG-FI measurements.

The Anatomy of the Ascending Pharyngeal Artery and Its Implication for Neurosurgical and Endovascular Procedures

Skull Base ◽  
2007 ◽  
Vol 17 (S 2) ◽  
Author(s):  
Daniel Cavalcanti ◽  
Cassius Reis ◽  
Ricardo Hanel ◽  
Sam Safavi-Abassi ◽  
Pushpa Deshmukh ◽  
...  
Keyword(s):  
Endovascular Procedures ◽  
Ascending Pharyngeal Artery

Studi Histokimia Usus Biawak Air (Varanus salvator bivittatus) (Reptil: Varanidae)

2019 ◽  
Author(s):  
Mahfud Mahfud ◽  
Ernawati
Keyword(s):  
Tissue Sample ◽  
Histological Section ◽  
Tissue Perfusion ◽  
Intestinal Wall ◽  
Biological Information ◽  
Suitable Habitat ◽  
Monitor Lizard ◽  
Varanus Salvator ◽  
Hematoxylin Eosin ◽  
Paraffin Method

Biological information, behaviour and suitable habitat of water monitor was very less in order to support its maintenance management and breeding efforts. One of important information is the information of digestive tract, particularly the information about the structure of intestine tissue of water monitor. Sample in this research was intestine organ of water monitor. The animal was anesthetized, exanguinated, and fixed in paraformaldehyde 4% by tissue perfusion method. The intestine tissue sample for histological section with paraffin method was cutted with 3-4 μm thick and coloured with hematoxylin eosin (HE). Observation were performed to the structure of intestine histology. The results was analysed descriptively and presented in figures. Monitor lizard intestine consist of small intestine and large intestine. The small intestinal wall was observed similar to jejunum and ileum. The large intestinal wall was composed of transitional ephytelia and connective tissue. However, the ephytelial layer in this tissue was composed of transitional ephytelia that similar to vesica urinaria and there are no villi.

Anatomi Saluran Pencernaan biawak air (Varanus salvator) (Reptil: Varanidae)

2019 ◽  
Author(s):  
Mahfud Mahfud ◽  
Ihwan
Keyword(s):  
Small Intestine ◽  
Digestive Tract ◽  
Large Intestine ◽  
Scientific Information ◽  
Tissue Perfusion ◽  
Animal Population ◽  
Varanus Salvator ◽  
Commercial Purpose ◽  
Left And Right ◽  
Biology Laboratory

Excessive hunting and poaching for commercial purpose of Varanus salvator in Indonesia can cause a decline in this animal population. However, the scientific information of this animal especially about the biologic of organ system is rarely reported. Therefore, this case opens up opportunities for researching, which aims to study the anatomy of digestive tract of water monitor macroscopically. This research has been conducted in Biology Laboratory, University of Muhammadiyah Kupang for 5 months from March to August 2016. The digestive organ of this animal that has been preserved in alcohol 70% was obtained before from two males of water monitors. Preservation process: the animal were anesthetized, exsanguinated, and fixated in 4 paraformaldehyde by tissue perfusion method. Observations were performed to the visceral site and morphometrical of digestive tract. The resulted data was analysed descriptively and presented in tables and figures. The digestive tract of water monitor consist of esophagus, stomach, small intestine, large intestine and cloaca. The dimension of each organ is different based on its structures and functions. The esophagus of water monitor connects the mouth cavity and the stomach and also as the entrance of food to the stomach. Water monitor stomach were found in cranial part of abdomen, in left side of liver. The small intestine was longer than stomach and it is a winding muscular tube in abdomen in posterior side of liver. The large intestine consist of colon and cloaca, while cecum was not found. This channel was extend lateromedially in abdomen to cloaca between left and right kidneys. The cloaca was the end of digestive tract which excreted feces and urine. From this research, we can conclude that the digestive tract of water monitor consists of esophagus, stomach, small intestine, and large intestine. It’s difficult to differentiate small intestine and large intestine because there are no cecum.

Impaired Myocardial Tissue Perfusion Early After Successful Thrombolysis

Circulation ◽  
1995 ◽  
Vol 92 (8) ◽  
pp. 2072-2078 ◽  
Author(s):  
Alex Maes ◽  
Frans Van de Werf ◽  
Johan Nuyts ◽  
Guy Bormans ◽  
Walter Desmet ◽  
...  
Keyword(s):  
Tissue Perfusion ◽  
Myocardial Tissue ◽  
Successful Thrombolysis

Blood flow and high-energy phosphates in microregions of left ventricular subendocardium

1981 ◽  
Vol 240 (5) ◽  
pp. H804-H810 ◽  
Author(s):  
H. D. Kleinert ◽  
H. R. Weiss
Keyword(s):  
Blood Flow ◽  
Linear Relationship ◽  
Tissue Perfusion ◽  
High Energy ◽  
Left Ventricular ◽  
Significant Loss ◽  
Tissue Blood Flow ◽  
High Energy Phosphates ◽  
Tissue Samples ◽  
Heterogeneous Distribution

Blood flow and high-energy phosphate (HEP) content were determined simultaneously in multiple microregions of left ventricular subendocardium in 29 normal anesthetized open-chest rabbits by use of a new micromethod to determine whether a direct linear relationship existed between these parameters. Tissue samples weighed 1-2 mg. ATP and creatine phosphate (CP) content were quantitated in quick-frozen hearts by fluorometry at sites where tissue perfusion was measured by H2 clearance by use of bare-tipped platinum electrodes. A series of validation studies were conducted to ensure that 1) no significant damage to the tissue surrounding the electrode occurred during the period of experimentation and 2) no significant loss of biochemical constituents had occurred due to labile processes during freezing or storage of the tissue. Blood flow, ATP, and CP values averaged 79.1 +/- 24.1 (SD) ml.min-1.100 g-1, 4.9 +/- 1.3 mumol/g tissue, and 8.0 +/- 3.0 mumol/g tissue, respectively, and are similar to those reported in studies using larger tissue samples. Correlation between the heterogeneous distribution of tissue perfusion and HEP revealed no direct linear relationship between these parameters in the normal unstressed rabbit subendocardium.

scholarly journals Effects of capillary refill time-vs. lactate-targeted fluid resuscitation on regional, microcirculatory and hypoxia-related perfusion parameters in septic shock: a randomized controlled trial

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Ricardo Castro ◽  
Eduardo Kattan ◽  
Giorgio Ferri ◽  
Ronald Pairumani ◽  
Emilio Daniel Valenzuela ◽  
...  
Keyword(s):  
Septic Shock ◽  
Randomized Controlled Trial ◽  
Fluid Resuscitation ◽  
Controlled Trial ◽  
Tissue Perfusion ◽  
Capillary Refill Time ◽  
Capillary Refill ◽  
Randomized Controlled ◽  
Microcirculatory Flow ◽  
The Impact

Abstract Background Persistent hyperlactatemia has been considered as a signal of tissue hypoperfusion in septic shock patients, but multiple non-hypoperfusion-related pathogenic mechanisms could be involved. Therefore, pursuing lactate normalization may lead to the risk of fluid overload. Peripheral perfusion, assessed by the capillary refill time (CRT), could be an effective alternative resuscitation target as recently demonstrated by the ANDROMEDA-SHOCK trial. We designed the present randomized controlled trial to address the impact of a CRT-targeted (CRT-T) vs. a lactate-targeted (LAC-T) fluid resuscitation strategy on fluid balances within 24 h of septic shock diagnosis. In addition, we compared the effects of both strategies on organ dysfunction, regional and microcirculatory flow, and tissue hypoxia surrogates. Results Forty-two fluid-responsive septic shock patients were randomized into CRT-T or LAC-T groups. Fluids were administered until target achievement during the 6 h intervention period, or until safety criteria were met. CRT-T was aimed at CRT normalization (≤ 3 s), whereas in LAC-T the goal was lactate normalization (≤ 2 mmol/L) or a 20% decrease every 2 h. Multimodal perfusion monitoring included sublingual microcirculatory assessment; plasma-disappearance rate of indocyanine green; muscle oxygen saturation; central venous-arterial pCO2 gradient/ arterial-venous O2 content difference ratio; and lactate/pyruvate ratio. There was no difference between CRT-T vs. LAC-T in 6 h-fluid boluses (875 [375–2625] vs. 1500 [1000–2000], p = 0.3), or balances (982[249–2833] vs. 15,800 [740–6587, p = 0.2]). CRT-T was associated with a higher achievement of the predefined perfusion target (62 vs. 24, p = 0.03). No significant differences in perfusion-related variables or hypoxia surrogates were observed. Conclusions CRT-targeted fluid resuscitation was not superior to a lactate-targeted one on fluid administration or balances. However, it was associated with comparable effects on regional and microcirculatory flow parameters and hypoxia surrogates, and a faster achievement of the predefined resuscitation target. Our data suggest that stopping fluids in patients with CRT ≤ 3 s appears as safe in terms of tissue perfusion. Clinical Trials: ClinicalTrials.gov Identifier: NCT03762005 (Retrospectively registered on December 3rd 2018)

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