The occurrence of peripheral arterial disease and the frequency of revascularization surgeries carried out on symptomatic individuals are on a constant upward trajectory. Nonetheless, ambiguity persists around both the hemodynamic surveillance post-revascularization and the ability to anticipate clinical endpoints. The present investigation was designed to probe hemodynamic measures, with particular attention directed at the microvasculature. This single-site, prospective research comprised 29 patients (15 suffering from intermittent claudication [IC] and 14 afflicted by chronic limb-threatening ischemia [CLTI]). Beyond the ankle–brachial index (ABI), we gauged microperfusion metrics—specifically microvascular blood flow, capillary oxygen saturation (SO2), and relative hemoglobin content (rHb)—before and after the revascularization intervention using an oxygen-to-see (O2C) apparatus that combines lightguide spectrophotometry with laser Doppler flowmetry. Recordings were taken with the limb positioned horizontally and elevated. At baseline, the SO2 value obtained with the leg elevated was substantially lower in the CLTI cohort than in the IC cohort (P = 0.0189); in contrast, the remaining microcirculatory measures and the ABI figures did not reach statistical significance. Diabetic subjects displayed a higher flow rate than non-diabetic subjects when the leg was in the horizontal position (P = 0.0162), a disparity that disappeared in the elevated posture. In the wake of successful revascularization, flow increased promptly and significantly, irrespective of leg position, whereas SO2, rHb, and the ABI remained unchanged. Elevated-leg SO2 was markedly lower in CLTI than in clinically compensated peripheral arterial disease, whereas microvascular flow served as a suitable surrogate marker of successful revascularization. In investigations involving surgical or interventional revascularization techniques, noninvasive hemodynamic monitoring of the pedal microcirculation could prove valuable.
