Noninvasive Assessment of Lower-extremity Hemodynamics in Individuals with Diabetes Mellitus

2010 ◽  
Vol 100 (5) ◽  
pp. 406-411 ◽  
Author(s):  
Charles A. Andersen

The timely and accurate noninvasive assessment of peripheral arterial disease is a critical component of a limb preservation initiative in patients with diabetes mellitus. Noninvasive vascular studies can be useful in screening patients with diabetes for peripheral arterial disease. In patients with clinical signs or symptoms, noninvasive vascular studies provide crucial information on the presence, location, and severity of peripheral arterial disease and an objective assessment of the potential for primary healing of an index wound or a surgical incision. Appropriately selected noninvasive vascular studies are important in the decision-making process to determine whether and what type of intervention might be most appropriate given the clinical circumstances. Hemodynamic monitoring is likewise important after either an endovascular procedure or a surgical bypass. Surveillance studies, usually with a combination of physiologic testing and imaging with duplex ultrasound, accurately identify recurrent disease before the occurrence of thrombosis, allowing targeted reintervention. Noninvasive vascular studies can be broadly grouped into three general categories: physiologic or hemodynamic measurements, anatomical imaging, and measurements of tissue perfusion. These types of tests and suggestions for their appropriate application in patients with diabetes are reviewed. (J Am Podiatr Med Assoc 100(5): 406–411, 2010)

2016 ◽  
Vol 15 (1) ◽  
pp. 42-49 ◽  
Author(s):  
D. A. Usanov ◽  
A. V. Skripal ◽  
S. N. Potakhin ◽  
A. A. Sagaidachnyi ◽  
A. V. Fomin ◽  
...  

The aim of the study - thermography-based analysis of lower limb vascular response to thermal impact in patients with trophic disorders, diabetes mellitus and peripheral atherosclerosis. Materials and methods. Thermal impact was carried out using the heating pad acting for 20 minutes. Control of temperature of back of the feet was performed by thermal imaging camera with a thermal sensitivity of 0.02°C. The study involved a group of 8 subjects without vascular disorders of the lower limbs (controls), and patient group of 8 subjects with trophic disorders due to the progression of diabetes and atherosclerosis (age of 67±8 years). All patients had type 2 diabetes and peripheral arterial disease with different levels and the degree of the main arterial occlusion. Intensity of trophic disorders changed from apical necrosis and trophic ulcers to gangrene of the foot. We calculated spectral amplitude parameters and temperature dynamics. Fourier transform was used to perform spectral analysis of temperature data. Results. Temperature response of limbs in patients with diabetes compared with healthy subjects was characterized by monotonous temperature variation without distinct oscillations; reduction in amplitude of oscillations within endothelial temperature range; relatively high average temperature difference between the left and right foot. In the group of healthy subjects reaction on thermal impact is not strictly two-stage, usually interpretable by theory as primary and secondary vasodilation. Conclusions. Decrease of temperature amplitude of endothelial range registered during thermal impact can be the sign of endothelial dysfunction in patients with diabetes and peripheral arterial disease. Spectral and temperature characteristics of reaction of limbs on thermal impact can be used to assess trophic disorders and compensation mechanisms of regulation of metabolic processes in the group of patients with diabetes mellitus.


2013 ◽  
Vol 03 (02) ◽  
pp. 79-85 ◽  
Author(s):  
Javier Ena ◽  
Carlos R. Argente ◽  
Víctor González-Sánchez ◽  
Natividad Algado ◽  
Gema Verdú ◽  
...  

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