Tag: microcirculation

We Moved to the Toe to Escape Calcification — and It Followed Us There: Digital Artery Calcification, Falsely-High Toe Pressures, and a 20–30 mmHg Temporary Fix #DiabeticFoot #PAD #CLTI #ToePressure #Calcification #LimbPreservation #ActAgainstAmputation @alpslimb

We moved to the toe pressure precisely because digital arteries were supposed to be spared from calcification. A new JVS-Vascular Insights study from Welling, Bakker, Ferraresi and colleagues finds digital artery calcification in nearly 30% of limbs, shows it doubles one-year limb-event risk, and that it falsely elevates toe pressure — with a simple fix: when calcium shows on the foot film, subtract 20–30 mmHg.

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If It Doesn’t Look Like a Tree: #Fractals, #Microcirculation, and Why Small Artery Disease Is So Easy to See

A long-time friend's offhand observation in Bremen — that small artery disease is easy to see on an angiogram because it doesn't look like nature — leads to Mandelbrot, Murray's law, and a quantifiable complexity index for the diabetic foot.

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Get the Balance Right: How Much Pressure Is Too Much for the Diabetic Foot? #ActAgainstAmputation

When it comes to neuropathic (and likely neuroischemic) diabetic foot ulcers (DFUs), pressure and perfusion are often at odds. In an elegant study, Zhang and colleagues from Fudan University and Shanghai Jiao Tong University have quantified how the skin’s microcirculation responds to physiologic, gait-like pressure—and when that response begins to fail . 🚶‍♂️Walking the Line: Pressure... Continue Reading →

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Effect of Exercise Volume on Plantar Microcirculation and Tissue Hardness in People With Type 2 Diabetes

While only about 10-15% of the patients had peripheral neuropathy and were, therefore, at risk for ulceration, these data from Ren and coworkers are nonetheless compelling. Perhaps a subsequent study for high risk patients? Objective: Exercise has been reported to be beneficial for people with type 2 diabetes (T2DM), but exercise, especially weight-bearing exercise, may increase... Continue Reading →

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Stratification of Microvascular Disease Severity in the Foot Using Spatial Frequency Domain Imaging

Work from our combined UofA and USC team with our colleagues at Modulim. Samuel Jett 1, Mallory R Thompson 2, Shubhangi Awasthi 2, David J Cuccia 1, Tze-Woei Tan 2, David G Armstrong 3, Amaan Mazhar 1, Craig C Weinkauf 2 Background: Microvascular disease (MVD) describes systemic changes in the small vessels (~100 um diameter) that impair tissue oxygenation and perfusion. MVD is a common but poorly monitored complication of diabetes.... Continue Reading →

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