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DOI: 10.1055/a-0838-5209
Thermographic Characteristics of the Diabetic Foot With Peripheral Arterial Disease Using the Angiosome Concept
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Abstract
Aim To compare temperature changes following a challenge of limb elevation, in 3 forefoot angiosomes between type 2 diabetes mellitus patients with and without peripheral arterial disease (PAD).
Methods Participans were categorized in a no PAD, mild PAD or severe PAD group. All underwent thermal imaging, then successive thermal images were taken at 1 min intervals after the lower limbs were elevated for 5 min. Thereafter, the lower limbs were lowered to the original position and imaged after 1 min. Mean temperatures of the hallux, medial and lateral forefoot were analysed by the angiosome concept.
Results Forty-two limbs were analysed. Mean resting temperatures of all angiosomes of participants with PAD were higher than those with no peripheral arterial disease. A significant difference in the mean initial temperature between the groups was found in the medial and lateral forefoot angiosomes (p=0.048, p=0.049 respectively), whilst at the hallux these temperatures were not significant (p=0.165). After limb elevation, the only significant difference was seen in the lateral foot area at 1 min (p=0.021).
Conclusions These results confirm that patients with PAD exhibit significantly higher forefoot temperatures, according to the angiosome concept. The challenge by foot elevation did not affect the thermal pattern significantly.
Publikationsverlauf
Eingereicht: 15. November 2018
Eingereicht: 02. Januar 2019
Angenommen: 17. Januar 2019
Artikel online veröffentlicht:
14. März 2019
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References
- 1 Hirsch AT, Criqui MH, Treat-Jacobson D. et al. Peripheral arterial disease detection, awareness, and treatment in primary care. JAMA 2001; 286: 1317-1324
- 2 Shah AM, Banerjee T, Mukherjee D. Coronary, peripheral and cerebrovascular disease: A Complex relationship. J Indian Med Assoc 2010; 108: 292-294
- 3 Norgren L, Hiatt W, Dormandy J. et al. Inter-Society Consensus for the Management of Peripheral Arterial Disease (TASCII). Eur J Vasc Endovasc Surg 2007; 33 (Supp1): S1-S75
- 4 Formosa C, Cassar K, Gatt K. et al. Hidden dangers revealed by misdiagnosed peripheral arterial disease using ABPI measurement. Diabetes Res Clin Pract 2013; 102: 112-116
- 5 Silva NCM, Castro HA, Carvalho LC. et al. Reliability of infrared thermography images in the analysis of the plantar surface temperature in diabetes mellitus. J Chiropr Med 2018; 17: 30-35
- 6 Bagavathiappan S, Saravanan T, Philip J. et al. Infrared thermal imaging for detection of peripheral vascular disorders. J Med Phys 2009; 34: 43-47
- 7 Huang C, Wu Y, Hwang C. et al. The application of infrared thermography in evaluation of patients at high risk for lower extremity peripheral arterial disease. J Vasc Surg 2001; 54: 1074-1080
- 8 Nagase T, Sanada H, Takehara K. et al. Variations of plantar thermographic patterns in normal controls and nonulcer diabetic patients: Novel classification using angiosome concept. Journal of Plastic, J Plast Reconstr Aesthet Surg 2011; 64: 860-866
- 9 Gatt A, Cassar K, Falzon O. et al. The identification of higher forefoot temperatures associated with peripheral arterial disease in type 2 diabetes mellitus as detected by thermography. Prim Care Diabetes 2018; 12: 312-318
- 10 Gatt A, O. Falzon O, Cassar K. et al. Establishing differences in thermographic patterns between the various complications in diabetic foot disease. Int J Endocrinol 12.03.2018; 9808295 DOI: 10.1155/2018/9808295. eCollection 2018
- 11 Gatt A, Formosa C, Cassar K. et al. Thermographic patterns of the upper and lower limbs: Baseline data. Int J Vasc Med 2015; 831369 DOI: 10.1155/2015/831369. Epub 2015 Jan 13
- 12 Armstrong DG, Lavery LA, Liswood PJ. et al. Infrared dermal thermometry for the high-risk diabetic foot. Phys Ther 1997; 77 1997 169-175
- 13 Attinger CE, Evans KK, Bulan E. et al. Angiosomes of the foot and ankle and clinical implications for limb salvage: Reconstruction, incisions, and revascularization. Plast Reconstr Surg 2006; 117 (Suppl. 07) 261S-293S
- 14 Kawasaki T, Uemura T, Matsuo K. et al. The effect of different positions on lower limbs skin perfusion pressure. J Indian Med Assoc 2013; 46: 508-512
-
15 WMA. - The World Medical Association-WMA Declaration of Helsinki – Ethical Principles for Medical Research Involving Human Subjects. 2013 Retrieved August 16, 2017, from https://www.wma.net/policies-post/wma-declaration-ofhelsinki-ethical-principles-for-medical-research-involving-human-subjects/
- 16 Azzopardi YM, Gatt A, Chockalingam N. et al. Agreement of clinical tests for the diagnosis of peripheral arterial disease. Prim Care Diabetes 2019; 13: 82-86
- 17 Aboyans V, Mcclelland R. Allison. et al. Lower extremity peripheral artery disease in the absence of traditional risk factors. The Multi-Ethnic Study of Atherosclerosis. Atherosclerosis 2011; 214: 169-173
- 18 Kagaya Y, Ohura N, Suga H. et al. ‘Real Angiosome’ Assessment from peripheral tissue perfusion using tissue oxygen saturation foot-mapping in patients with critical limb ischemia. Eur J Vasc Endovasc Surg 2014; 47: 433-441
- 19 Georgakarakos E, Papanas N, Papadaki E. et al. Endovascular treatment of critical ischemia in the diabetic foot: New thresholds, new anatomies. Angiology 2013; 64: 583-591
- 20 Chae KJ, Shin JY. Is angiosome targeted angioplasty effective for limb salvage and wound healing in diabetic foot? A Meta-analysis. PLOS One 21.07.2016; DOI: 10.1371/journal.pone.0159523. 11(7): e0159523 eCollection 2016