Original Articles from the Midwestern Vascular Surgical SocietyThe correlation between three methods of skin perfusion pressure measurement: Radionuclide washout, laser Doppler flow, and photoplethysmography*,**
Section snippets
Methods
We compared the SPP using the radionuclide washout method to the SPP measured simultaneously by placing laser Doppler and PPG probes within a transparent blood pressure cuff in 13 limbs. The mean age of normal subjects was 34.5 years and of patients with ischemic limbs 67.3 years (range, 26 to 77 years).
The experimental protocol was approved by the Internal Review Board of Morristown Memorial Hospital for use with human subjects, all of whom gave informed consent.
Only the return of
Results
The range of SPP determined by radionuclide washout was 0 to 100;SPP-laser Doppler was 0 to 100; and SPP-PPG was 60 to 100, with 7 of 13 limbs demonstrating no clear deflection point on PPG, and thus giving no obtainable SPP. A marked deflection of the PPG in the DC mode is the result of a sudden influx of blood. When the pressure is deflated over a long period of time, no sudden influx results, and there is no clear deflection in our experience.
Linear regression revealed a coefficient of
Discussion
The diabetic patient with occlusive vascular disease is difficult to evaluate accurately with noninvasive methods. 10, 11, 12 Segmental systolic pressures are unreliable because of medial calcification; the more accurate indexes obtained with toe pressures are often impossible to measure in this population either because of direct involvement of the digit in the gangrenous process or because of previous minor amputations. Toe pressure measurements are difficult to make at low values, and in the
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Cited by (40)
Photoplethysmography for the assessment of peripheral vascular disease
2021, Photoplethysmography: Technology, Signal Analysis and ApplicationsVasodilator Response Correlates with Outcome in Chronic Critical Limb Ischemia
2010, Journal of Surgical ResearchCitation Excerpt :SPP was determined using a laser Doppler scanner (LASERDOPP PV2000; Vasamedics, Eden Prairie, MN). The measurements were performed as described by Malvezzi et al. [10]. The patient was placed in the supine position in a room at temperature of 24 to 25°C.
When is a more proximal amputation needed?
2005, Clinics in Podiatric Medicine and SurgeryLaser Doppler skin perfusion pressure in the assessment of Raynaud's phenomenon
2004, European Journal of Vascular and Endovascular SurgeryCitation Excerpt :Castronuovo et al. reported a new non-invasive technique for skin perfusion pressure measurement using laser Doppler.12 Measurement with a laser Doppler probe can be performed in a few minutes and its result correlates well with the results of skin perfusion pressure by means of the radionuclide washout method.6,12 Non-invasive examinations with the laser Doppler method have now been widely used in vascular laboratories.
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Supported by the Reeves Surgical Research Fund.
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Reprint requests: John J. Castronuovo, Jr., MD, Department of Surgery, Morristown Memorial Hospital, 100 Madison Ave., Morristown, NJ 07962-1956.