Peripheral Arterial Disease Clinical Trial
Official title:
Study of Parameters of Infracyanine Angiography as Diagnostic Tool of Critical Limb Ischemia
Investigators conduct a monocentric pilot study with the objective to determine the hemodynamic parameter of fluorescence angiography (slope, amplitude, saturation time ) best correlated with toe pressure in patients with suspicion of critical limb ischemia.
Critical limb ischemia, defined as the presence of chronic ischemic rest pain, ulcers or
gangrene attributable to objectively proven arterial occlusive disease, is associated with
the appalling prospect that approximately 30% will lose their leg and 25% will die at one
year. Despite the progress of therapeutics these statistics haven't changed. Critical limb
ischemia is a clinical diagnosis but should be supported by objective tests. None of theses
tests (toe blood pressure (TBP), transcutaneous oxygen pressure (TcPO2) and skin perfusion
pressure (SPP)) have proven to be enough specific or sensitive, more so they are time
consuming, can be subject to several artifacts and may be in some cases discordant making
diagnosis difficult. Fluorescence angiography has long been used in ophthalmology for the
evaluation of the microcirculation of the retina. Infracyanine remains within the
intravascular space allowing the visualization of the vasculature to a depth of 10 mm. With
the Fluobeam system, images to a maximal width of 20 cm can be obtained therefore allowing
the evaluation of the tissue perfusion of the entire foot.
Method: Fluorescence angiography is performed in the laboratory in the same time as TCPO2,
TP and SPP. Infracyanine is injected in an antecubital vein and visualization and signal
acquisition carried out using a specific camera device (Fluoptic SAS, France) producing the
time course of hemodynamic parameters (slope, amplitude, saturation time).
30patients will be evaluated with correlation between data obtained by fluorescence
angiography and too blood pressure
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