A Real-Time Blood Flow Measurement Device for Patients with Peripheral Artery Disease
| Autor: | Mahmood K. Razavi, D. Preston Flanigan, Tyler B. Rice, Sean M. White |
|---|---|
| Rok vydání: | 2021 |
| Předmět: |
Male
medicine.medical_specialty Light Arterial disease Critical Illness Diagnostic Techniques Cardiovascular Pilot Projects Disease Severity of Illness Index 030218 nuclear medicine & medical imaging Peripheral Arterial Disease 03 medical and health sciences 0302 clinical medicine Measurement device Ischemia Predictive Value of Tests Internal medicine medicine Humans Scattering Radiation Ankle Brachial Index Radiology Nuclear Medicine and imaging Prospective Studies Prospective cohort study Aged Aged 80 and over Receiver operating characteristic business.industry Area under the curve Reproducibility of Results Equipment Design Critical limb ischemia Blood flow Middle Aged body regions Cross-Sectional Studies Regional Blood Flow 030220 oncology & carcinogenesis Cardiology Feasibility Studies Female medicine.symptom Cardiology and Cardiovascular Medicine business Blood Flow Velocity |
| Zdroj: | Journal of Vascular and Interventional Radiology. 32:453-458 |
| ISSN: | 1051-0443 |
| DOI: | 10.1016/j.jvir.2020.09.006 |
| Popis: | Purpose To evaluate the feasibility of a new optical device that measures peripheral blood flow as a diagnostic and monitoring tool for patients with peripheral artery disease (PAD). Materials and Methods In this prospective study, 167 limbs of 90 patients (mean age, 76 y; 53% men) with suspected PAD were evaluated with the FlowMet device, which uses a new type of dynamic light-scattering technology to assess blood flow in real time. Measurements of magnitude and phasicity of blood flow were combined into a single-value flow–waveform score and compared vs ankle–brachial index (ABI), toe–brachial index (TBI), and clinical presentation of patients per Rutherford category (RC). Receiver operating characteristic curves were constructed to predict RC. Area under the curve (AUC), sensitivity, and specificity were compared among flow–waveform score, ABI, and TBI. Results Qualitatively, the FlowMet waveforms were analogous to Doppler velocity measurements, and degradation of waveform phasicity and amplitude were observed with increasing PAD severity. Quantitatively, the flow, waveform, and composite flow–waveform scores decreased significantly with decreasing TBI. In predicting RC ≥ 4, the flow–waveform score (AUC = 0.83) showed a linear decrease with worsening patient symptoms and power comparable to that of TBI (AUC = 0.82) and better than that of ABI (AUC = 0.71). Optimal sensitivity and specificity pairs were found to be 56%/83%, 72%/81%, and 89%/74% for ABI, TBI, and flow–waveform score, respectively. Conclusions The technology tested in this pilot study showed a high predictive value for diagnosis of critical limb ischemia. The device showed promise as a diagnostic tool capable of providing clinical feedback in real time. |
| Databáze: | OpenAIRE |
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