University of Twente Student Theses
Non-invasive monitoring of tissue perfusion in patients with peripheral arterial obstructive disease after endovascular revascularisation
Nijboer, T.S. (2021) Non-invasive monitoring of tissue perfusion in patients with peripheral arterial obstructive disease after endovascular revascularisation.
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| Abstract: | Introduction – Peripheral arterial obstructive disease (PAOD) is characterised by the (partial) occlusion of at least one of the large or medium sized peripheral arteries, caused by atherosclerosis. All current diagnostic modalities focus on the detection and quantification of occlusions in the macrovasculature. However, local tissue perfusion monitoring can be of more interest to quantify disease progression and predict treatment outcomes. Aim - The aim of this thesis is to accomplish post-acquisition processing of hyperspectral images (HSI) to: • Improve analysis consistency of hyperspectral follow-up images using automated image registration. • Determine the performance of hyperspectral imaging and temperature measurements in disease quantification of PAOD patients during follow-up after a revascularisation procedure. Methods – HSI and thermal imaging consisted of a baseline measurement and six follow-up measurements. During follow-up, measurements were performed at 1 hour, 4 hours, 1 day, 7 days, 14 days, and 6 weeks after endovascular treatment (EVT). Images were most consistently analysed when manual segmentation of HSI and thermal images of the dorsal and plantar side was performed. Subsequently, the segmentations of the HSI images were reduced to 3 mm from the edged and artefacts, due to reliability of these values. Finally, all measurements were scaled relative to baseline measurement. The trends over time of temperature, oxygenised haemoglobin (OxyHb) and deoxygenised haemoglobin (DeoxyHb) levels were evaluated, based on feet without missing data. Two groups were evaluated: patients with and without clinical improvement after six weeks. Next, perfusion parameters which showed a difference between the two groups were analysed with respect to clinical improvement after 6 weeks. Differences between the groups were tested using Mann-Whitney U test. Results - OxyHb levels of the plantar and dorsal side of the foot showed a stable trend with no difference compared to baseline for both groups. DeoxyHb levels decreased directly after EVT for patients with and without clinical improvement after six weeks. However, patients with no clinical improvement showed an increase of DeoxyHb levels to baseline levels or higher 4 hours after EVT, whereas patients with clinical improvement showed this increase 7 days after EVT. Temperature in both groups increased compared to baseline 1 and 4 hours after EVT, with a return to baseline levels during the remaining follow-up. Subsequently, differences in DeoxyHb levels between the groups was assessed. A significant difference (p<0.01) between both groups was found 7 days after EVT, measured on the plantar side of the foot. Conclusion - This study is the first to investigate HSI levels and temperature of the foot at multiple stages, including at home, during follow-up after EVT. DeoxyHb levels measured 7 days after EVT on the plantar side of the foot may distinguish patients with and without clinical improvement after six weeks, but these results should be reconfirmed in a larger series of patients before widespread implementation can be advised. |
| Item Type: | Essay (Master) |
| Clients: | UMCG, Groningen |
| Faculty: | TNW: Science and Technology |
| Subject: | 44 medicine |
| Programme: | Technical Medicine MSc (60033) |
| Link to this item: | https://purl.utwente.nl/essays/89150 |
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