Infrared Thermography as a Diagnostic Tool for the Assessment of Patients with Symptomatic Peripheral Arterial Disease Undergoing Infrafemoral Endovascular Revascularisations
Abstract
:1. Introduction
2. Materials and Methods
2.1. Subjects
2.2. Thermographic Measurement Procedure
2.3. Foot Temperature
2.4. Ankle–Brachial Index
2.5. Statistical Analysis
3. Results
3.1. Baseline value of Foot Temperature
3.2. Revascularisation Procedures and Foot Temperature Changes
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
- Peach, G.; Griffin, M.; Jones, K.G.; Thompson, M.M.; Hinchliffe, R.J. Diagnosis and management of peripheral arterial disease. Br. Med. J. 2012, 345, e5208. [Google Scholar] [CrossRef] [Green Version]
- Humphries, M.D.; Brunson, A.; Hedayati, N.; Romano, P.; Melnkow, J. Amputation Risk in Patients with Diabetes Mellitus and Peripheral Artery Disease Using Statewide Data. Ann. Vasc. Surg. 2016, 30, 123–131. [Google Scholar] [CrossRef] [Green Version]
- Gerhard-Herman, M.D.; Gornik, H.L.; Barrett, C.; Barshes, N.R.; Corriere, M.A.; Drachman, D.E.; Fleisher, L.A.; Fowkes, F.G.R.; Hamburg, N.M.; Kinlay, S.; et al. 2016 AHA/ACC Guideline on the Management of Patients With Lower Extremity Peripheral Artery Disease: Executive Summary: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. J. Am. Coll. Cardiol. 2017, 69, 1465–1508. [Google Scholar] [CrossRef] [PubMed]
- Bajwa, A.; Wesolowski, R.; Patel, A.; Saha, P.; Ludwinski, F.; Smith, A.; Nagel, E.; Modarai, B. Assessment of tissue perfusion in the lower limb: Current methods and techniques under development. Circ. Cardiovasc. Imaging 2014, 7, 836–843. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Boezeman, R.P.; Moll, F.L.; Ünlü, Ç.; de Vries, J.P.P. Systematic review of clinical applications of monitoring muscle tissue oxygenation with near-infrared spectroscopy in vascular disease. Microvasc. Res. 2016, 104, 11–22. [Google Scholar] [CrossRef] [PubMed]
- Manfredini, F.; Lamberti, N.; Rossi, T.; Mascoli, F.; Basaglia, N.; Zamboni, P. A Toe Flexion NIRS assisted Test for Rapid Assessment of Foot Perfusion in Peripheral Arterial Disease: Feasibility, Validity, and Diagnostic Accuracy. Eur. J. Vasc. Endovasc. Surg. 2017, 54, 187–194. [Google Scholar] [CrossRef] [PubMed]
- Manfredini, F.; Lamberti, N.; Ficarra, V.; Tsolaki, E.; Straudi, S.; Zamboni, P.; Basaglia, N.; Gasbarro, V. Biomarkers of Muscle Metabolism in Peripheral Artery Disease: A Dynamic NIRS-Assisted Study to Detect Adaptations Following Revascularization and Exercise Training. Diagnostics 2020, 10, 312. [Google Scholar] [CrossRef] [PubMed]
- Huang, C.L.; Wu, Y.W.; Hwang, C.L.; Jong, Y.S.; Chao, C.L.; Chen, W.J.; Wu, Y.T.; Yang, W.S. The application of infrared thermography in evaluation of patients at high risk for lower extremity peripheral arterial disease. J. Vasc. Surg. 2011, 54, 1074–1080. [Google Scholar] [CrossRef] [Green Version]
- Peleki, A.; da Silva, A. Novel Use of Smartphone-based Infrared Imaging in the Detection of Acute Limb Ischaemia. EJVES Short Rep. 2016, 32, 1–3. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Staffa, E.; Bernard, V.; Kubicek, L.; Vlachovsky, R.; Vlk, D.; Mornstein, V.; Bourek, A.; Staffa, R. Infrared thermography as option for evaluating the treatment effect of percutaneous transluminal angioplasty by patients with peripheral arterial disease. Vascular 2017, 25, 42–49. [Google Scholar] [CrossRef] [PubMed]
- Von Elm, E.; Altman, D.G.; Egger, M.; Pocock, S.J.; Gøtzsche, P.C.; Vandenbroucke, J.P.; Strobe Initiative STROBE Initiative. Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement: Guidelines for reporting observational studies. BMJ 2007, 335, 806–808. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Aboyans, V.; Ricco, J.B.; Bartelink, M.E.L.; Björck, M.; Brodmann, M.; Cohnert, T.; Collet, J.-P.; Czerny, M.; De Carlo, M.; Debus, S.; et al. ESC Scientific Document Group. 2017 ESC Guidelines on the Diagnosis and Treatment of Peripheral Arterial Diseases, in collaboration with the European Society for Vascular Surgery (ESVS): Document covering atherosclerotic disease of extracranial carotid and vertebral, mesenteric, renal, upper and lower extremity arteries Endorsed by: The European Stroke Organization (ESO)The Task Force for the Diagnosis and Treatment of Peripheral Arterial Diseases of the European Society of Cardiology (ESC) and of the European Society for Vascular Surgery (ESVS). Eur. Heart J. 2018, 39, 763–816. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Lahiri, B.B.; Bagavathiappan, S.; Jayakumar, T.; Philip, J. Medical applications of infrared thermography: A review. Infrared Phys. Technol. 2012, 55, 221–235. [Google Scholar] [CrossRef] [PubMed]
- Fernández-Cuevas, I.; Marins, J.C.B.; Lastras, J.A.; Carmona, P.M.G.; Cano, S.P.; García-Concepción, M.Á.; Sillero-Quintana, M. Classification of factors influencing the use of infrared thermography in humans: A review. Infrared Phys. Technol. 2015, 71, 28–55. [Google Scholar] [CrossRef]
- Will, R.K.; Ring, E.F.J.; Clarke, A.K.; Maddison, P.J. Maddison Infrared thermography, what is its place in rheumatology in the 1990′s. Rheumatology 1992, 31, 337–344. [Google Scholar] [CrossRef]
- Ilo, A.; Romsi, P.; Mäkelä, J. Infrared thermography and vascular disorders in diabetic feet. J. Diabetes Sci. Technol. 2020, 14, 28–36. [Google Scholar] [CrossRef]
- Conte, M.S.; Bradbury, A.W.; Kolh, P.; White, J.V.; Dick, F.; Fitridge, R.; Mills, J.L.; Ricco, J.B.; Suresh, K.R.; Murad, M.H.; et al. Writing Group for the Joint Guidelines of the Society for Vascular Surgery (SVS), European Society for Vascular Surgery (ESVS), and World Federation of Vascular Societies (WFVS). Global Vascular Guidelines on the Management of Chronic Limb-Threatening Ischemia. Eur. J. Vasc. Endovasc. Surg. 2019, 58, S1–S109.e33. [Google Scholar] [CrossRef] [Green Version]
- Katsuki, T.; Yamaji, K.; Tomoi, Y.; Hiramori, S.; Soga, Y.; Ando, K. Clinical impact of improvement in the ankle-brachial index after endovascular therapy for peripheral arterial disease. Heart Vessel 2020, 35, 177–186. [Google Scholar] [CrossRef]
- Ilo, A.; Romsi, P.; Mäkelä, J. Infrared Thermography as a Diagnostic Tool for Peripheral Artery Disease. Adv. Skin Wound Care 2020, 33, 482–488. [Google Scholar] [CrossRef]
- Manfredini, F.; Lamberti, N.; Traina, L.; Zenunaj, G.; Medini, C.; Piva, G.; Straudi, S.; Manfredini, R.; Gasbarro, V. Effectiveness of Home-Based Pain-Free Exercise versus Walking Advice in Patients with Peripheral Artery Disease: A Randomized Controlled Trial. Methods Protoc. 2021, 4, 29. [Google Scholar] [CrossRef]
- Firnhaber, J.M.; Powell, C.S. Lower Extremity Peripheral Artery Disease: Diagnosis and Treatment. Am. Fam. Physician 2019, 99, 362–369. [Google Scholar] [PubMed]
- Criqui, M.H.; Aboyans, V. Epidemiology of peripheral artery disease. Circ. Res. 2015, 116, 1509–1526. [Google Scholar] [CrossRef] [Green Version]
- Manfredini, F.; Malagoni, A.M.; Manfredini, R. Ankle brachial pressure index: Faulty or overused? Angiology 2013, 64, 89–92. [Google Scholar] [CrossRef] [PubMed]
- Silva, N.C.; Castro, H.A.; Carvalho, L.C.; Chaves, É.C.; Ruela, L.O.; Iunes, D.H. Reliability of Infrared Thermography Images in the Analysis of the Plantar Surface Temperature in Diabetes Mellitus. J. Chiropr. Med. 2018, 17, 30–35. [Google Scholar] [CrossRef] [PubMed]
- Lin, P.H.; Saines, M. Assessment of lower extremity ischemia using smartphone thermographic imaging. J. Vasc. Surg. Cases Innov. Tech. 2017, 3, 205–208. [Google Scholar] [CrossRef] [PubMed] [Green Version]
Demographics and Comorbidities | Patients (n = 40) |
---|---|
Age | 76 ± 11 |
Male | 27 (67.5%) |
Female | 13 (32.5%) |
Current smokers | 6 (15%) |
Systemic hypertension | 34 (85%) |
Under beta blockers medication | 21 (52.5%) |
Under calcium antagonists medication | 25 (62.5%) |
Under beta-blockers and calcium antagonists | 15 (37.5%) |
Dyslipidaemia | 19 (47.5%) |
Diabetes mellitus | 23 (57.5%) |
Chronic renal failure | 8 (20%) |
CAD | 19 (47.5%) |
COPD | 11 (27.5%) |
Neoplasia | 6 (15%) |
Connetival disease | 6 (15%) |
Stroke | 3 (7.5%) |
Charlson index | 3.79 ± 1.73 |
ABI | |
ABI before revascularisation | 0.31 ± 0.19 |
Antomical segment/Endovascular procedures | |
Femoro-popliteal | 22 (55%) |
Balloon angioplasty | 17 (42.5%) |
Balloon angioplasty + SFA stenting | 5 (12.5%) |
Below the knee Balloon angioplasty | 9 (22.5%) |
Above and below the knee Balloon angiopasty Balloon angioplasty of BTKs + SFA stenting | 9 (22.5%) |
Minor amputations | 4 (10%) |
Wound debridements | 6 (15%) |
Stage of PAD | |
Rutherford Category 3 | 5 (12.5%) |
Rutherford Category 4 | 10 (25%) |
Rutherford Category 5 | 17 (42.5%) |
Rutherford Category 6 | 8 (20%) |
More Impaired Limb | Less Impaired Limb | p Value | |
---|---|---|---|
Anterior tibial | 32.7 ± 1.8 | 34.1 ± 1.4 | <0.001 |
Posterior tibial | 32.9 ± 1.6 | 34.1 ± 1.2 | <0.001 |
Dorsalis pedis | 31.7 ± 2.2 | 33.5 ± 1.6 | <0.001 |
Arcuate | 31.7 ± 2.1 | 33.6 ± 1.5 | <0.001 |
Mean value | 32.2 ± 1.8 | 33.9 ± 1.3 | <0.001 |
Grade 3 (n = 5) | Grade 4 (n = 10) | Grade 5 (n = 17) | Grade 6 (n = 8) | p Value | |
---|---|---|---|---|---|
Anterior tibial | 33.9 ± 1.8 | 32.6 ± 1.4 | 32.9 ± 1.9 | 31.7 ± 1.3 | 0.15 |
Posterior tibial | 33.6 ± 1.9 | 32.5 ± 1.4 | 33.3 ± 1.4 | 31.9 ± 1.3 | 0.08 |
Dorsalis pedis | 33.9 ± 2.1 | 31.8 ± 2.0 | 31.4 ± 1.6 | 30.2 ± 2.1 | 0.016 |
Arcuate | 34.0 ± 1.7 | 31.8 ± 2.0 | 31.5 ± 1.6 | 30.0 ± 2.0 | 0.007 |
Mean value | 33.9 ± 1.9 | 32.2 ± 1.7 | 32.4 ± 1.7 | 30.9 ± 1.4 | 0.016 |
More Impaired Limb | Less Impaired Limb | |||||
---|---|---|---|---|---|---|
Before | After | p Value | Before | After | p Value | |
Anterior tibial | 32.7 ± 1.8 | 34.6 ± 1.6 | <0.001 | 34.1 ± 1.4 | 34.6 ± 1.6 | 0.35 |
Posterior tibial | 32.9 ± 1.6 | 34.8 ± 1.5 | <0.001 | 34.1 ± 1.2 | 34.6 ± 1.7 | 0.41 |
Dorsalis pedis | 31.7 ± 2.2 | 34.0 ± 1.9 | <0.001 | 33.5 ± 1.6 | 34.1 ± 1.6 | 0.22 |
Arcuate | 31.7 ± 2.1 | 34.0 ± 2.0 | <0.001 | 33.6 ± 1.5 | 34.1 ± 1.6 | 0.44 |
Mean value | 32.2 ± 1.8 | 34.3 ± 1.7 | <0.001 | 33.9 ± 1.3 | 34.4 ± 1.5 | 0.52 |
Publisher’s Note: MDPI stays neutral with regard to jurisdictional claims in published maps and institutional affiliations. |
© 2021 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
Share and Cite
Zenunaj, G.; Lamberti, N.; Manfredini, F.; Traina, L.; Acciarri, P.; Bisogno, F.; Scian, S.; Serra, R.; Abatangelo, G.; Gasbarro, V. Infrared Thermography as a Diagnostic Tool for the Assessment of Patients with Symptomatic Peripheral Arterial Disease Undergoing Infrafemoral Endovascular Revascularisations. Diagnostics 2021, 11, 1701. https://doi.org/10.3390/diagnostics11091701
Zenunaj G, Lamberti N, Manfredini F, Traina L, Acciarri P, Bisogno F, Scian S, Serra R, Abatangelo G, Gasbarro V. Infrared Thermography as a Diagnostic Tool for the Assessment of Patients with Symptomatic Peripheral Arterial Disease Undergoing Infrafemoral Endovascular Revascularisations. Diagnostics. 2021; 11(9):1701. https://doi.org/10.3390/diagnostics11091701
Chicago/Turabian StyleZenunaj, Gladiol, Nicola Lamberti, Fabio Manfredini, Luca Traina, Pierfilippo Acciarri, Francesca Bisogno, Sabrina Scian, Raffaele Serra, Giulio Abatangelo, and Vincenzo Gasbarro. 2021. "Infrared Thermography as a Diagnostic Tool for the Assessment of Patients with Symptomatic Peripheral Arterial Disease Undergoing Infrafemoral Endovascular Revascularisations" Diagnostics 11, no. 9: 1701. https://doi.org/10.3390/diagnostics11091701