Impact of Peripheral Angioplasty on Wound Oxygenation and Healing in Patients with Chronic Limb-Threatening Ischemia Measured by Near-Infrared Spectroscopy

Managing chronic limb-threatening ischemia (CLTI) is challenging due to difficulties in assessing tissue oxygen saturation in ulcers. Near-infrared spectroscopy (NIRS) is a non-invasive method for measuring tissue oxygen saturation (StO₂). This study evaluated the effects of endovascular treatment (EVT) on StO₂ and wound healing in CLTI patients, comparing NIRS to standard ankle-brachial index (ABI) measurements. Using the Duesseldorf PTA Registry, 43 CLTI patients were analyzed: 27 underwent EVT, and 16 received conservative treatment. ABI assessed macrocirculation, while NIRS measured wound, wound area, and mean foot StO₂ at baseline, post-EVT, and four-month follow-up. Wound severity was classified by wound area and wound, ischemia, and foot infection (WIfI) score. Wound StO₂ increased significantly (median (interquartile range (IQR)), 38 (49.3) to 60 (34.5)%, <i>p</i> = 0.004), as did wound area StO₂ (median (IQR), 70.9 (21.6) to 72.8 (18.3)%, <i>p</i> < 0.001), with no significant changes in the control group by four-month follow-up. Wound area decreased significantly after EVT (mean ± SD, 343.1 ± 267.8 to 178.1 ± 268.5 mm², <i>p</i> = 0.01) but not in the control group. Changes in wound StO₂, wound area StO₂, and WIfI score correlated with wound area reduction, unlike ABI. This small exploratory study shows that NIRS-measured StO₂ improvements after EVT correlate with reduced wound area and WIfI scores, highlighting NIRS as a potential enhancement for CLTI wound management in addition to ABI.