Applications

Critical Limb Ischaemia (CLI)

The term critical limb ischaemia (CLI) is used to describe patients with a typical ischaemic pain at rest (TASC II) and occurs as a manifestation of peripheral artery disease. In patients with critical limb ischaemia the number of capillaries is reduced, and vascular fields can be seen in patients with severe cases of the disease. As such, it is very important that patients with critical limb ischaemia are identified rapidly as they are at a high risk of limb loss or other fatal and non-fatal vascular events (TASC II). Laser Doppler is commonly used in the testing of critical limb ischaemia. One such test used as an aid for the diagnosis of critical limb ischaemia is the calculation of toe pressure to assess distal perfusion. This can be simply and rapidly achieved using the moorVMS-LDF and moorVMS-PRES, with automatic calculations of toe pressure and printable reports available with the dedicated moorVMS-VASC software.

Ankle pressure (mmHg) in CLI <50
Toe pressure (mmHg) in CLI <30
ABPI (ratio) in CLI <0.5

Table – Important measures of pressure in critical limb ischaemia (Piaggesi et al, 2009, TASC II 2007)

Equipment Recommendations

We recommend the moorVMS-VASC PC software for this application as it features an easy to use user interface to streamline measurements and automate reporting. The software automatically controls cuff pressure with moorVMS-PRES and displays the blood flow response measurements from the moorVMS-LDF monitor (Probe choice VP1T or VP1T/7). Toe cuffs are available for use with moorVMS-PRES.

Vascular Monitoring System
moorVMS-VASC

Non-invasive assessment of micro-vascular blood flow in response to standard, and your custom, pressure cuff inflation protocols

Accessories

moorVMS-LDF - Advanced, laser Doppler blood flow and temperature monitor
moorVMS-PRES - Automatic pressure cuff control for routine microvascular testing
VP1T - A combined temperature and optic probe that delivers light at a right angle to the probe cable
VP1T/7 - A combined temperature and optic probe that delivers light at a right angle to the probe cable with 8 collecting fibres in a 2mm ring with a central delivery fibre

What Next?

Contact us to discuss your specific needs and to request your copy of our free Application Note which includes a detailed experimental method and practical suggestions. We also offer no obligation on-site visits so you can test the equipment in your facility.

References

Norgren L., Hiatt W. R., Dormandy J. A., Nehler M. R., Harris K. A., Fowkes F. G. R. on behalf of the TASC II Working Group.2007
Inter-Society Consensus for the Management of Peripheral Arterial Disease (TASC II).
European Journal of Vascular and Endovascular Surgery, 33, S1eS75

Piaggesi A., Rizzo L., Tedeschi A., Scatena A., Goretti C., Del Prato S. 2009
Measurements in Diabetic Foot
Journal of Wound Technology, No. 3, pp 19-23

TASC II 2007
Summary of the Inter-Society Consensus for the management of PAD (TASC II) guidelines.
Published January 2007 www.tasc-2-pad.org Section D: Chronic Critical Limb Ischaemia

Ubbink, D, Th. 2004
Toe blood pressure measurements in patients suspected of leg ischaemia: A new laser Doppler device compared with photoplethysmography.
European Journal of Endovascular Surgery, 27, pp 629-634