DIABETES COMPLICATIONS - Development of a New Tool for Obliterating Arteriopathy of the Lower Limbs Detection

Stéphane Roeslin, Nadège Marthouret, Louis Benazet, Christophe Roncato, Gabriel Camelot, Anca Loppinet, Xavier Racadot, Sylvie Grandperret, Hayet Bourezane, Christian Pieralli, Lionel Pazart, Bruno Wacogne

Abstract

Obliterating arteriopathy of the lower limbs (OALL) is a common complication in diabetes. This vasculopathy, which is associated with mild injury and with the diabetic neuropathy, is the source of diabetic foot ulcers which precede approximately 85% of amputations. Simple measures may avoid this dreaded complication if it is identified in time. OALL detection is currently undertaken by measuring ankle systolic pressure. The latter could be evaluated with microcirculatory technique but these techniques have a number of limitations: time consumption and cost. OALL detection is therefore limited to a small number of specialized units. In order to allow detection of OALL in ambulatory medicine, we propose a simple system based on photoplethysmography. The idea is to apply a pre-set "warning" pressure to the patient's toe and to optically check if arterial pulsation still exists. If not, the patient is directed to the adequate hospital unit for full diagnosis. This "warning" system which can easily be used at the general practitioner’s office is meant to help detecting the OALL at an early stage, hence reducing the number of amputations. In this position paper, we present the system, some early results and we propose a discussion concerning the screening of OALL.

References

  1. Becker, F. 1989, Classification Clinique et hémodynamique des artériopathies oblitérantes des members inférieurs, PhD Thesis, Burgondy University.
  2. Boccalon, H., 2004, Artériopathies des membres inférieurs chez le diabétique, La revue de médecine interne, Vol.25, pp. S337-S338, doi:10.1016/j.revmed.2004. 10.2008.
  3. Carter, S. A., Tate, R. B., 1996, Value of toe pulse waves in addition to systolic pressures in the assessment of the severity of peripheral disease and critical limb ischemia, J. Vasc. Surg., Vol. 24, pp. 258-265.
  4. De Graff, J. C., Ubbink, D. T., Legemate, D. A., Tijssen, J. G. P., Jacobs, M., 2003, Evaluation of toe pressure and transcutaneous oxygen measurements in management of chronic critical leg ischemia: a diagnostic randomized clinical trial, J. of Vasc. Surge., Vol. 38, pp. 528-234.
  5. Girach, A., Vignati, L., 2006, Diabetic microvascular complications - can the presence of one predict the development of another ?, J. Diabetes and its compl., Vol.20, pp. 228-237.
  6. HAS report, 2006, Prise en charge de l'arthériopathie chronique oblitérante artéroscléreuse des members inférieurs, http://www.has-sante.fr/portail/upload/docs /application/pdf/AOMI_fiche.pdf
  7. Johanson, K. E. A., Marklund, B. R. G., Fowelin, J. H. R., 2002, Evaluation of a new screening method for detecting peripheral arterial disease in primary health care population of patients with biabetes mellitus, Diab. Med., Vol. 19, pp. 307-310.
  8. Kröger, K., Stewen, C., Santosa, F., Rudofsky, G., 2003, Toe pressure measurement compared to ankle artery pressure measurements, Angiology, Vol. 54, pp. 39-44.
  9. Moe, S. M., O'Neill, K. D., Duan, D., Ahmed, S., Chen, Stephen, N. X., Leapman, S. B., Fineberg, N., Kopecky, K., 2002, Medial artery calcification in ESRD patients is associated with deposition of bone matrix proteins, Kindney Int., Vol. 61, pp. 638-647.
  10. VALMI, 2008, Veines, Artères, Lymphatiques, Microcirculation, http://cemv.vascular-e-learning.net/ Valmi
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Paper Citation


in Harvard Style

Roeslin S., Marthouret N., Benazet L., Roncato C., Camelot G., Loppinet A., Racadot X., Grandperret S., Bourezane H., Pieralli C., Pazart L. and Wacogne B. (2012). DIABETES COMPLICATIONS - Development of a New Tool for Obliterating Arteriopathy of the Lower Limbs Detection . In Proceedings of the International Conference on Biomedical Electronics and Devices - Volume 1: BIODEVICES, (BIOSTEC 2012) ISBN 978-989-8425-91-1, pages 93-98. DOI: 10.5220/0003703700930098


in Bibtex Style

@conference{biodevices12,
author={Stéphane Roeslin and Nadège Marthouret and Louis Benazet and Christophe Roncato and Gabriel Camelot and Anca Loppinet and Xavier Racadot and Sylvie Grandperret and Hayet Bourezane and Christian Pieralli and Lionel Pazart and Bruno Wacogne},
title={DIABETES COMPLICATIONS - Development of a New Tool for Obliterating Arteriopathy of the Lower Limbs Detection},
booktitle={Proceedings of the International Conference on Biomedical Electronics and Devices - Volume 1: BIODEVICES, (BIOSTEC 2012)},
year={2012},
pages={93-98},
publisher={SciTePress},
organization={INSTICC},
doi={10.5220/0003703700930098},
isbn={978-989-8425-91-1},
}


in EndNote Style

TY - CONF
JO - Proceedings of the International Conference on Biomedical Electronics and Devices - Volume 1: BIODEVICES, (BIOSTEC 2012)
TI - DIABETES COMPLICATIONS - Development of a New Tool for Obliterating Arteriopathy of the Lower Limbs Detection
SN - 978-989-8425-91-1
AU - Roeslin S.
AU - Marthouret N.
AU - Benazet L.
AU - Roncato C.
AU - Camelot G.
AU - Loppinet A.
AU - Racadot X.
AU - Grandperret S.
AU - Bourezane H.
AU - Pieralli C.
AU - Pazart L.
AU - Wacogne B.
PY - 2012
SP - 93
EP - 98
DO - 10.5220/0003703700930098