Laser Doppler Flowmetry in Lower Extremity Ischemia: Application and Interpretation

Raphael Walden, Arie Bass, Moshe Balaciano, Michaela Modan, Lea Zulty, Raphael Adar

Research output: Contribution to journalArticlepeer-review

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.

Original languageEnglish
Pages (from-to)511-516
Number of pages6
JournalAnnals of Vascular Surgery
Volume6
Issue number6
DOIs
StatePublished - 1992

Keywords

  • Laser Doppler flowmetry
  • ischemia
  • lower extremity ischemia
  • peripheral vascular disease

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