Abstract
OBJECTIVE: The portable, non-invasive laser Doppler flowmeter (LDF) provides a practical alternative, enabling bedside blood flow assessment for chronic limb threatening ischaemia (CLTI). The present study aimed to evaluate whether LDF could identify CLTI and to assess the utility of LDF in determining the efficacy of revascularisation. METHODS: The study enrolled 50 patients with non-lower extremity arterial disease (LEAD) and 24 patients with CLTI (25 limbs) from March 2021 to December 2024; blood flow in the dorsal and plantar areas was measured using a portable LDF (Pocket LDF, JMS Co., Ltd., Tokyo, Japan). Blood flow and skin perfusion pressure (SPP) were compared before and after surgical bypass, and correlations between LDF and SPP were also determined for 17 limbs with CLTI. RESULTS: The mean dorsal plantar blood flow was 12.0 ± 9.3 and 13.3 ± 6.6 mL/min for the non-LEAD and CLTI groups, respectively (p = .48), however, the mean plantar blood flow was statistically significant lower in the CLTI group (26.1 ± 11.7 mL/min) than in the non-LEAD group (52.2 ± 18.6 mL/min, p < .001). In the 17 limbs with CLTI that underwent surgical bypass, the mean blood flow in the dorsal area was 13.7 ± 5.5 and 15.7 ± 6.2 mL/min before and after surgery, respectively (p = .30). However, the post-operative mean plantar blood flow improved statistically significant (45.4 ± 18.6 mL/min) from its pre-operative status (25.0 ± 11.8 mL/min, p < .001). The mean SPP changes before and after surgical bypass were 27.3 ± 14.7 and 52.7 ± 18.3 mmHg, respectively (p < .001), in the dorsal area, showing improvement in correlation with the LDF measurements (p = .023). CONCLUSION: The portable LDF measurement in the plantar area may help in identifying CLTI and evaluating the effectiveness of revascularisation.