{"title":"评估外周动脉疾病和糖尿病患者组织灌注的无创光学方法:范围综述与讨论","authors":"Manal Ahmad MBBch, BaO, MRCS, MMedSc, PGCMedEd, MAcadMEd , Kirtan Patel BSc, MBBS, MRCS, PGCMedEd , Alun Huw Davies MA, DM, DSc, FRCS, FHEA, FEBVS, FACPh , Joseph Shalhoub BSc, MBBS, FHEA, PhD, Med, FRCS, FEBVS","doi":"10.1016/j.jvsvi.2023.100034","DOIUrl":null,"url":null,"abstract":"<div><h3>Background</h3><p>The global incidence of peripheral arterial disease (PAD) is 10.5 million individuals annually. There are 113 million people affected globally, which can result in limb loss. PAD is often part of a greater set of comorbidities, including diabetes mellitus (DM), chronic kidney disease, coronary artery disease and obesity. Diabetic foot ulceration is a debilitating complication of DM that occurs owing to a combination of neuropathy, PAD, and structural biomechanical changes. Poor tissue perfusion in the context of microangiopathy can result in impaired wound healing and eventual limb loss. The combination of diabetic foot ulceration and PAD can be burdensome socially, psychologically and economically, for patients and health systems. It is, therefore, imperative to be able to identify and continuously monitor high-risk patients to aid in the prevention, monitoring, and management of these conditions in a noninvasive, easily accessible and cost-effective manner. We sought to evaluate the current evidence relating to noninvasive optical tissue perfusion assessment modalities available and their use in patients with PAD and individuals with DM. We also aimed to collate how each assessment modality worked, and its advantages and disadvantages.</p></div><div><h3>Methods</h3><p>A systematic literature search was conducted of the Embase and Medline (via the Ovid interface), PubMed, and Google Scholar databases for articles relating to PAD in individuals with DM. Articles were reviewed by two independent reviewers. Findings were collated for each method of tissue perfusion.</p></div><div><h3>Results</h3><p>In the final review, 35 articles met criteria for inclusion. The modalities discussed included photoplethysmography, spatial frequency domain imaging, hyperspectral imaging, laser Doppler, laser speckle flowgraphy, near infrared spectroscopy, thermography, photoacoustic imaging, and indocyanine green.</p></div><div><h3>Conclusions</h3><p>Several modalities are available for the noninvasive monitoring of tissue perfusion in individuals with DM and PAD that show promise. Their clinical applicability is an area of ongoing research.</p></div>","PeriodicalId":74034,"journal":{"name":"JVS-vascular insights","volume":null,"pages":null},"PeriodicalIF":0.0000,"publicationDate":"2023-11-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2949912723000314/pdfft?md5=c05459894060ea0e1f38103043fde7e6&pid=1-s2.0-S2949912723000314-main.pdf","citationCount":"0","resultStr":"{\"title\":\"Noninvasive optical methods to assess tissue perfusion in patients with peripheral arterial disease and diabetes mellitus: A scoping review and discussion\",\"authors\":\"Manal Ahmad MBBch, BaO, MRCS, MMedSc, PGCMedEd, MAcadMEd , Kirtan Patel BSc, MBBS, MRCS, PGCMedEd , Alun Huw Davies MA, DM, DSc, FRCS, FHEA, FEBVS, FACPh , Joseph Shalhoub BSc, MBBS, FHEA, PhD, Med, FRCS, FEBVS\",\"doi\":\"10.1016/j.jvsvi.2023.100034\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Background</h3><p>The global incidence of peripheral arterial disease (PAD) is 10.5 million individuals annually. There are 113 million people affected globally, which can result in limb loss. PAD is often part of a greater set of comorbidities, including diabetes mellitus (DM), chronic kidney disease, coronary artery disease and obesity. Diabetic foot ulceration is a debilitating complication of DM that occurs owing to a combination of neuropathy, PAD, and structural biomechanical changes. Poor tissue perfusion in the context of microangiopathy can result in impaired wound healing and eventual limb loss. The combination of diabetic foot ulceration and PAD can be burdensome socially, psychologically and economically, for patients and health systems. It is, therefore, imperative to be able to identify and continuously monitor high-risk patients to aid in the prevention, monitoring, and management of these conditions in a noninvasive, easily accessible and cost-effective manner. We sought to evaluate the current evidence relating to noninvasive optical tissue perfusion assessment modalities available and their use in patients with PAD and individuals with DM. We also aimed to collate how each assessment modality worked, and its advantages and disadvantages.</p></div><div><h3>Methods</h3><p>A systematic literature search was conducted of the Embase and Medline (via the Ovid interface), PubMed, and Google Scholar databases for articles relating to PAD in individuals with DM. Articles were reviewed by two independent reviewers. Findings were collated for each method of tissue perfusion.</p></div><div><h3>Results</h3><p>In the final review, 35 articles met criteria for inclusion. The modalities discussed included photoplethysmography, spatial frequency domain imaging, hyperspectral imaging, laser Doppler, laser speckle flowgraphy, near infrared spectroscopy, thermography, photoacoustic imaging, and indocyanine green.</p></div><div><h3>Conclusions</h3><p>Several modalities are available for the noninvasive monitoring of tissue perfusion in individuals with DM and PAD that show promise. 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引用次数: 0
摘要
背景外周动脉疾病(PAD)的全球发病率为每年 1,050 万人。全球有 1.13 亿人受到影响,可能导致肢体缺失。PAD 通常是糖尿病(DM)、慢性肾病、冠状动脉疾病和肥胖症等多种并发症的一部分。糖尿病足溃疡是一种使人衰弱的糖尿病并发症,是神经病变、PAD 和生物力学结构变化共同作用的结果。微血管病变导致的组织灌注不良会影响伤口愈合,最终导致肢体缺失。糖尿病足溃疡和 PAD 的结合会给患者和医疗系统带来沉重的社会、心理和经济负担。因此,当务之急是能够识别并持续监测高危患者,以非侵入性、易于获取和经济有效的方式帮助预防、监测和管理这些病症。我们试图评估与现有无创光学组织灌注评估方法有关的现有证据,以及这些方法在并发动脉粥样硬化症患者和糖尿病患者中的应用。我们还旨在整理每种评估方式的工作原理及其优缺点。方法在 Embase 和 Medline(通过 Ovid 界面)、PubMed 和 Google Scholar 数据库中进行了系统的文献检索,以查找与糖尿病患者 PAD 相关的文章。文章由两名独立审稿人进行审阅。结果在最终审查中,有 35 篇文章符合纳入标准。讨论的方式包括光电血压计、空间频域成像、高光谱成像、激光多普勒、激光斑点血流成像、近红外光谱、热成像、光声成像和吲哚青绿。它们的临床适用性是一个正在研究的领域。
Noninvasive optical methods to assess tissue perfusion in patients with peripheral arterial disease and diabetes mellitus: A scoping review and discussion
Background
The global incidence of peripheral arterial disease (PAD) is 10.5 million individuals annually. There are 113 million people affected globally, which can result in limb loss. PAD is often part of a greater set of comorbidities, including diabetes mellitus (DM), chronic kidney disease, coronary artery disease and obesity. Diabetic foot ulceration is a debilitating complication of DM that occurs owing to a combination of neuropathy, PAD, and structural biomechanical changes. Poor tissue perfusion in the context of microangiopathy can result in impaired wound healing and eventual limb loss. The combination of diabetic foot ulceration and PAD can be burdensome socially, psychologically and economically, for patients and health systems. It is, therefore, imperative to be able to identify and continuously monitor high-risk patients to aid in the prevention, monitoring, and management of these conditions in a noninvasive, easily accessible and cost-effective manner. We sought to evaluate the current evidence relating to noninvasive optical tissue perfusion assessment modalities available and their use in patients with PAD and individuals with DM. We also aimed to collate how each assessment modality worked, and its advantages and disadvantages.
Methods
A systematic literature search was conducted of the Embase and Medline (via the Ovid interface), PubMed, and Google Scholar databases for articles relating to PAD in individuals with DM. Articles were reviewed by two independent reviewers. Findings were collated for each method of tissue perfusion.
Results
In the final review, 35 articles met criteria for inclusion. The modalities discussed included photoplethysmography, spatial frequency domain imaging, hyperspectral imaging, laser Doppler, laser speckle flowgraphy, near infrared spectroscopy, thermography, photoacoustic imaging, and indocyanine green.
Conclusions
Several modalities are available for the noninvasive monitoring of tissue perfusion in individuals with DM and PAD that show promise. Their clinical applicability is an area of ongoing research.