Exercise Ischemia Induced by Essential Thrombocytemia Diagnosed on Treadmill Test - Transcutaneous Oxygen Pressure Measurement of Foot Ischemia -

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Exercise Transcutaneous Oximetry of the Buttocks, External Validation With Computed Tomography Angiography

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Performance of noninvasive laser Doppler flowmetry and laser speckle contrast imaging methods in diagnosis of Buerger disease. A case report

International audienceRationale: Buerger disease (BD) is a nonatherosclerotic, inflammatory, segmental vascular occlusive disease, which affects small and medium-sized arteries and veins and is triggered by substantial tobacco exposure. Angiographic findings consistent with BD are required for diagnosis. Laser Doppler flowmetry (LDF) and laser speckle contrast imaging (LSCI) could represent potential noninvasive alternative techniques to angiography.Patient concerns: We report the case of a 49-year-old smoker who developed an ischemic ulcer in the distal segment of the second finger of the left hand. He had no medical history.Diagnoses: In our vascular center, LDF and LSCI are conducted routinely for digital artery disease diagnosis. LDF was indicative of digital obstructive artery disease (DOAD). Postocclusive reactive hyperemia, assessed by LCSI, demonstrated no skin blood flow (SBF) perfusion in the distal phalanx of the thumb, index, middle, and auricular fingers. Angiography confirmed BD, showing distally located multisegmental vessel occlusion and corkscrew collaterals in this patient’s hands.Interventions: Ilomedine treatment was initiated and smoking cessation was definitive.Outcomes:Recently, the patient had an improvement in clinical condition despite the persistence of a small zone of necrosis of the left index finger 28 days post-treatment.Lessons: Our observation suggests that where suspicion of BD is based on clinical criteria, combining LDF and LSCI could represent a noninvasive, safe means of reaching BD diagnosis. Further clinical trials are necessary to confirm this novel observation

Vascular medicine residents lack adequate training for limb pressure measurement: A nationwide survey in France

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Description of Doppler waveforms to detect lower extremity peripheral artery disease

International audienceDoppler waveforms analysis is a interesting to diagnose peripheral artery disease as suggested by the international recommendations. However as mentioned in the present letter, there is a lack of consensus about the terminology that should be used

Necrobiotic xanthogranuloma a paraneoplastic skin lesion of haematological malignancies?

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Heterogeneity of Doppler waveform description is decreased with the use of a dedicated classification

International audienceBackground - The analysis of Doppler ultrasound waveforms (DW) provides a method for detecting and evaluating arterial stenosis in the lower limb arteries but no recommendation exists on how to describe the DWs. Aims of this study were to assess the heterogeneity of the description of DWs among vascular residents and the impact of the use of a 4-item classification. Methods - Thirty different DWs were presented to residents using Microsoft PowerPoint slides. They were invited to describe the 30 DWs before and after the presentation of a 4-item classification (triphasic, biphasic, monophasic, and others). The heterogeneity was assessed by the number of different answers used by the residents. Nineteen residents with six to eighteen months of vascular medicine training and ultrasound experience were included. Results - The average of different answers was 9 ± 4 for the whole analysis of the 30 DWs without the use of a specific classification, whereas the average was 2 ± 1 using the 4-item classification (p < 0.005). There was a significant difference in correct answers, i. e. in combined continuous waveforms and pulsed waveforms between experienced residents and younger residents (p < 0.05). Conclusions - Using a 4-item classification for DWs reduced the heterogeneity of the DW description. There is an urgent need to standardize the DW description in order to improve the patients care with peripheral artery disease

Validation of a software to perform exercise oximetry to diagnose arterial stenosis of the lower limbs

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