SM Vascular Medicine

Archive Articles

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Correlation of Near Infrared Spectroscopy Measurements of Tissue Oxygen Saturation with Transcutaneous pO2 in Patients with Chronic Wounds

Background: Assessment of tissue oxygenation and vascular function is an integral component in the management of chronic wounds. Current practice in wound centers is screening with Pulse Volume Recording (PVR) or Transcutaneous Oxygen Saturation (TCO2 ) to evaluate safety of compression wraps, utility for vascular intervention and expected response to Hyperbaric Oxygen Therapy (HBOT).

A near infrared (NIR) spectroscopy device (Kent, Calgary) using 4 wavelengths of light to determine Osaturation of hemoglobin (Hgb) in cutaneous tissue has been developed. The low absorption of light by H2O and melanin in the NIR range allows for measurement of absorption of deoxygenated and oxygenated hemoglobin and for the calculation of O2 saturation. The purpose of this study is to determine the correlation between the gold standard TCO2 and NIR spectroscopy in measuring cutaneous O2 .

Materials and methods: 20 patients with Fitzpatrick skin types I-III who had measurements of TCO2 (Perimed, Stockholm) also had simultaneous measurements obtained by NIR spectroscopy. The investigation was reviewed and approved by Institutional Review Board for Human Subjects at WVU. The Hemoglobin/ O2 dissociation curve at 370 degrees C, pH=7.4 and pCO2 =40 was used to calculate O2 saturations from measurement of TCO2 .

Results: Data pairs were analyzed using linear regression and the relationship y=0.93 x+5.35 with a correlation coefficient=0.92 and r2 =0.84 was calculated.

Conclusions: There was a significant correlation between measurements of tissue oxygenation using TCO2 and NIR spectroscopy. NIR spectroscopy has the advantage of not requiring skin contact and measurements can be taken even in the wound bed. Other advantages include: 1). Time (2 minutes vs. 90 minutes) and 2). Disposable cost ($150 –TCO2 vs. $0-NIR spectroscopy). 3). The ability to perform serial studies over time. Further studies are warranted to determine if this information is useful in determining response to HBOT or in predicting wound-healing trajectory

Robert E. Bowen, M.D.1*, Ginna Treadwell RN1 and Mark Goodwin RRT1


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Long-Term Survival of Korean Aortic Aneurysm Patients

The study aim is to determine factors affecting the long-term survival of subjects with Aortic Aneurysm (AA). The sample included 294 Korean patients aged ≥ 30 years who were hospitalized from 1994 through 2004. Diagnosis was confirmed in 294 AA subjects (18.4% in affected Coronary Artery Disease (CAD); 75.8% with abdominal only AA (AAA) and 24.2% with Thoracic AA (TAA)) by computed tomography angiography in Samsung Medical Center, Seoul, Korea. AA repair direct operation or percutaneous endovascular AA repair (Revascularized group) was performed for 60.3% of the patients. Death data were obtained from all participants between 1994 and 2009. The mean age of AA subjects was 68.7 (±8.1) years. The proportion of males was 82%. Five- and 10-year survival rates were 89.8% and 82.6%, respectively. The 5-and 10-year survival rates were 92.3% and 84.9% in revascularized group and 86.4% and 79.5% in non-revascularized group, respectively. Adjusted hazard ratios were 1.14 (95% Confidence Interval (CI) 1.06-1.22) in ages and 2.94 (95% CI 1.23-7.38) in smoking for AA. Age and smoking contributed to death in Korean AA patients. And the 10-year survival rate for AA patients in Korea was over 80%. Revascularized group shows higher survival rate than non-revascularized group.

Shin Yi Jang* and Duk-Kyung Kim


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Comparison of Flow Measurement by 4D Flow Magnetic Resonance Imaging and by Particles Image Velocimetry on Phantom of Abdominal Aortic Aneurysm

Predicting the rupture of Aortic Aneurysms is a complex problem that interests, from several decades, many researchers. The works on this issue are very complex, involving both the study of mechanical behavior of the artery as the flow of blood. The Magnetic Resonance Imaging (MRI) technique allows to obtain anatomic information of the arteries, than the flow inside thereof. The goal of this study is an inter comparison between flow data from MRI and those obtained by Particle Image Velocimetry (PIV). An experimental device simulating hemodynamic circulation is used. Initially in order to validate the device, the flow in a cylindrical glass tube is measured by these two techniques and then compared to a theoretical model. Secondly, the flow in a phantom in silicone, with an axisymmetric aneurysm, is evaluated with 4D flow MRI sequences and the measurements are compared with those obtained by PIV with good agreement. The ability of the MRI technique to measure the flow thus makes an essential device for the study of cardiovascular disease.

Yufei Wang1 , David Joannic1,2, Patrick Juillion1 , Alan Keromnes3 , Aurélien Monnet4 , Alain Lalande5 and Jean-François Fontaine1,2*