Localized irregularities in hemoglobin flow and oxygenation in calf muscle in patients with peripheral vascular disease detected with near-infrared spectrophotometry

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Localized irregularities in hemoglobin flow and oxygenation in calf muscle in patients with peripheral vascular disease detected with near-infrared spectrophotometry Ursula Wolf, MD, Martin Wolf, PhD, Jee H. Choi, MS, Moshe Levi, MD, Devasmita Choudhury, MD, Sherri Hull, BS, Daniel Coussirat, L.Adelina Paunescu, PhD, Larisa P. Safonova, PhD, Antonios Michalos, MD, William W. Mantulin, PhD, Enrico Gratton, PhD Journal of Vascular Surgery Volume 37, Issue 5, Pages 1017-1026 (May 2003) DOI: 10.1067/mva.2003.214 Copyright © 2003 Society for Vascular Surgery and The American Association for Vascular Surgery Terms and Conditions

Fig. 1 Light is emitted at source location. It penetrates tissue before being detected at a given distance from source. Shaded area (light bundle) indicates approximate path of light. Journal of Vascular Surgery 2003 37, 1017-1026DOI: (10.1067/mva.2003.214) Copyright © 2003 Society for Vascular Surgery and The American Association for Vascular Surgery Terms and Conditions

Fig. 2 System setup. Sensor is placed on lateral calf, where it interrogates an area 18.5 × 6 cm. Journal of Vascular Surgery 2003 37, 1017-1026DOI: (10.1067/mva.2003.214) Copyright © 2003 Society for Vascular Surgery and The American Association for Vascular Surgery Terms and Conditions

Fig. 3 Two tracings of changes in [O2Hb] and [HHb] and pneumatic cuff pressure during venous occlusion. The two diagrams display tracings obtained from two different subjects at the same location on calf muscle. In all venous occlusions [O2Hb] and [HHb] increase (left), while in one venous occlusion of 180-second duration (right) [O2Hb], after initial increase, decreases. Journal of Vascular Surgery 2003 37, 1017-1026DOI: (10.1067/mva.2003.214) Copyright © 2003 Society for Vascular Surgery and The American Association for Vascular Surgery Terms and Conditions

Fig. 4 Correlation between ankle-brachial index (ABI) and Δ[tHb], hemoglobin flow (HF), and Svo2for distal region of calf muscle. Journal of Vascular Surgery 2003 37, 1017-1026DOI: (10.1067/mva.2003.214) Copyright © 2003 Society for Vascular Surgery and The American Association for Vascular Surgery Terms and Conditions

Fig. 5 Color-coded maps represent view from posterior on subject lateral calf muscles during venous occlusion. Columns represent variables O2Hb, total hemoglobin (tHb), and Svo2, and rows correspond to a particular subject. Scale for each parameter is given at bottom. Subject A is characteristic of healthy subjects, with increase in [O2Hb] and [tHb] is higher proximally and medially. Svo2is above 70% throughout maps. In subject B, localized effect with lower increase in [O2Hb] and [tHb] and very low Svo2 is noted, while rest of muscle is perfused and oxygenated normally. In subject C, Svo2 drops considerably distally. ABI, Ankle-brachial index. Journal of Vascular Surgery 2003 37, 1017-1026DOI: (10.1067/mva.2003.214) Copyright © 2003 Society for Vascular Surgery and The American Association for Vascular Surgery Terms and Conditions

Fig. 6 Maps depict phenomenon of decrease in [O2Hb] from 60 to 180 seconds during venous occlusion. [O2Hb] decreases despite continuous increase in total hemoglobin (tHb). Effect can be generalized (subject D) or localized (subject E). Again, maps show it is possible to identify regions of irregular hemoglobin concentration increase and Svo2. Color-coded maps are analogous with those in Fig 5. ABI, Ankle-brachial index. Journal of Vascular Surgery 2003 37, 1017-1026DOI: (10.1067/mva.2003.214) Copyright © 2003 Society for Vascular Surgery and The American Association for Vascular Surgery Terms and Conditions