• Sotaro Katsui, Yoshinori Inoue, Kimihiro Igari, Takahiro Toyofuku, Toshifumi Kudo, and Hiroyuki Uetake.
• Department of Surgical Specialties, Tokyo Medical and Dental University, Tokyo, Japan.
• Lasers Surg Med. 2017 Sep 1; 49 (7): 645-651.

ObjectiveWe propose a new assessment tool to diagnose severe ischemia of the lower limb in peripheral arterial disease, using laser speckle contrast imaging to evaluate heating-induced microcirculatory fluctuations in the proximal and distal sites of the dorsal foot.Study DesignA cross-sectional study.MethodsWe recorded the slope describing the behavior of perfusion values (decrease or plateau) following the initial, heating-induced increase in perfusion in 63 feet of patients with clinical signs of peripheral arterial disease.ResultsThe plateau and decrease groups were defined as having perfusion slopes of <0.20 and ≥0.20 PU/min, respectively. Transcutaneous oxygen tension was significantly lower (P < 0.001) in the plateau than in the decrease group (8 vs. 45 mmHg), indicating more severe ischemia. The laser speckle contrast imaging thermal load test discriminated transcutaneous oxygen tension <30 mmHg with good sensitivity (78.7%) and specificity (96.2%), and an area under the curve of 0.908.ConclusionsBoth transcutaneous oxygen tension and the laser speckle contrast imaging thermal load test are useful in diagnosing severe ischemia in the foot. Lasers Surg. Med. 49:645-651, 2017. © 2017. The Authors. Lasers in Surgery and Medicine Published by Wiley Periodicals, Inc.© 2017 The Authors. Lasers in Surgery and Medicine Published by Wiley Periodicals, Inc.

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