Postintervention monitoring of peripheral arterial disease wound healing using dynamic vascular optical spectroscopy

Abstract

Significance: Due to the persistence of chronic wounds, a second surgical intervention is often necessary for patients with peripheral arterial disease (PAD) within a year of the first intervention. The dynamic vascular optical spectroscopy system (DVOS) may assist physicians in determining patient prognosis only a month after the first surgical intervention.

Aim: We aim to assess the DVOS utility in characterizing wound healing in PAD patients after endovascular intervention.

Approach: The DVOS used near-infrared light ( $670<\lambda <850\mathrm{nm}$ ) to record hemodynamic response to a cuff inflation in 14 PAD patients with lower limb ulcers immediately before, immediately after, and at a first follow-up 3 to 4 weeks after intervention. Ankle-brachial index (ABI) and arterial duplex ultrasound (A-DUS) measurements were obtained when possible.

Results: The total hemoglobin plateau time differed significantly between patients with ulcers that reduced in size ( $N=9$ ) and patients with ulcers that did not ( $N=5$ ) 3 to 4 weeks after intervention ( $p\text{value}<0.001$ ). Data correlated strongly (89% sensitivity, 100% specificity, and $\mathrm{AUC}=0.96$ ) with long-term wound healing. ABI and A-DUS measurements were not statistically associated with wound healing.

Conclusions: This pilot study demonstrates the potential of the DVOS to aid physicians in giving accurate long-term wound healing prognoses 1 month after intervention.

Keywords: dynamic optical spectroscopy; near-infrared spectroscopy; peripheral arterial disease; revascularization; wound healing.