Assessing Microcirculation Revascularization in Venous Leg Ulcer Patients Using Mobile Multispectral Near Infrared Spectroscopy Imaging Post-Treatment.

Introduction: Chronic venous insufficiency (CVI) is prevalent among the elderly population, with a documented prevalence rate of 1.69%.1 This condition can result in serious complications, including venous leg ulcers (VLU).2 VLU affects around 2.2 million Americans annually.3 VLU episodes can persist and reoccur over extended periods, substantially diminishing quality of life. This study explores the potential of mobile multispectral near-infrared spectroscopy (NIRS) imaging in detecting microcirculation revascularization post-treatment in individuals with CVI and VLUs.Methods:This retrospective study involved 22 patients treated with radiofrequency ablation (RFA) or ultrasound-guided foam/liquid sclerotherapy. Venous duplex ultrasound was performed before and after treatment to assess venous obstruction and reflux. Mobile multispectral NIRS and infrared (IR) thermal imaging device* measured tissue oxygenation (StO2) and skin temperature pre and post-treatment.Results:Patients treated with either RFA or sclerotherapy exhibited significant increases in StO2 post-treatment, indicating microcirculation revascularization. For example, following RFA, StO2 levels increased by 56% in the anterior leg and 80% in the dorsal foot. Similarly, sclerotherapy resulted in StO2 increase from 15% to 46% in the medial leg and 36% in the lateral leg. Additionally, when comparing StO2 levels between the treated site (e.g., right foot plantar and dorsal surfaces in the case of R GSV) and the untreated site, the mean oxygenation on the untreated side was higher (e.g., 55% vs. 44%). After treatment, both sites exhibited comparable StO2 levels, averaging around 53%.Discussion: Evaluating microcirculation revascularization post-treatment is crucial for assessing treatment efficacy and determining the necessity for further interventions. NIRS imaging shows promise in identifying early microcirculation changes, offering valuable insights into treatment outcomes at the point of care. This study emphasizes the potential of mobile multispectral NIRS imaging for assessing microcirculation revascularization in individuals with CVI and VLUs post-treatment.References: 1. Margolis, D. J., Bilker, W., Santanna, J. & Baumgarten, M. Venous leg ulcer: incidence and prevalence in the elderly. J. Am. Acad. Dermatol. 46, 381–386 (2002). 2. Bernatchez, S. F., Eysaman-Walker, J. & Weir, D. Venous Leg Ulcers: A Review of Published Assessment and Treatment Algorithms. Adv. Wound Care 11, 28–41 (2022). 3. Alavi, A. et al. What’s new: Management of venous leg ulcers: Approach to venous leg ulcers. J. Am. Acad. Dermatol. 74, 627–40; quiz 641–2 (2016).