The plantar-palmar index with near infrared spectroscopy as an alternative to the ankle-brachial index for non-invasive evaluation of vascular perfusion and peripheral arterial disease

Authors

  • Jonathan A Niezgoda William Carey University Author
  • Debarpan Das Kent Imaging Inc. Author
  • Najratun Nayem Pinky Kent Imaging Inc. Author
  • Sandeep Gopalakrishnan University of Wisconsin Author
  • Glyn Jones Kent Imaging Inc. Author
  • Richard Neville INOVA Schar Heart and Vascular Author
  • Craig Walker Louisiana State University Author
  • Jeffrey Niezgoda Kent Imaging Inc. Author

DOI:

https://doi.org/10.63676/m0ww6304

Keywords:

Ankle Brachial Index, Spectroscopy, Near-Infrared, Point-of-Care Systems, Peripheral Arterial Disease, Oxygen Saturation, Diabetes Mellitus, Vascular Calcification, Perfusion

Abstract

Aims: Peripheral arterial disease (PAD) contributes to significant morbidity, particularly in diabetic and high-risk vascular populations. While the ankle-brachial index (ABI) remains a diagnostic cornerstone, it exhibits poor sensitivity in patients with vascular calcification or diabetes. Near-infrared spectroscopy (NIRS), paired with a novel plantar-palmar index (PPI), offers a point-of-care, non-invasive, and real-time method for assessing tissue perfusion. This study evaluates the clinical correlation between the NIRS-derived PPI and pulse volume recordings (PVR), supporting its role as a replacement for ABI.

Methods: A prospective observational study was conducted on 91 limbs across 48 participants. Each limb underwent ABI and PVR testing, and NIRS imaging to measure corresponding oxygen saturation (StO2) values. The PPI was calculated as the ratio of plantar StO2 to palmar StO2. PPI values were compared across PVR-defined disease states using ANOVA with pairwise comparisons.

Results: Estimated margin means for PPI increased with disease severity: normal (1.054), mild (1.178), moderate (1.376), and severe (1.430). PPI significantly distinguished normal from all PAD classes (p<0.005). NIRS imaging demonstrated clear perfusion patterns aligned with PVR classification.

Conclusion: PPI derived from NIRS strongly correlates with PVR and offers a viable, non-invasive alternative to ABI, particularly in populations where interpretation of ABI is limited. Broader clinical implementation could redefine vascular screening strategies.

Author Biographies

  • Jonathan A Niezgoda, William Carey University

    William Carey University, College of Osteopathic Medicine, Hattiesburg, MS

  • Debarpan Das, Kent Imaging Inc.

    Clinical Research Specialist, Kent Imaging Inc., Calgary Canada

  • Najratun Nayem Pinky, Kent Imaging Inc.

    Director of Clinical Research, Kent Imaging Inc., Calgary Canada

  • Sandeep Gopalakrishnan, University of Wisconsin

    Associate Professor, Biomedical Sciences, Director, Wound Healing and Tissue Repair Analytics Laboratory, University of Wisconsin, Milwaukee, WI

  • Glyn Jones, Kent Imaging Inc.

    CMO Surgery Kent Imaging Inc., Calgary Canada

  • Richard Neville, INOVA Schar Heart and Vascular

    Associate Director, INOVA Schar Heart and Vascular, Chief, Vascular Surgery, Wound Care, Hyperbaric Medicine, Falls Church, VA

  • Craig Walker, Louisiana State University

    Clinical Professor of Medicine Tulane/Louisiana State University, Medical Director, Cardiovascular Institute of the South, Houma, LA

  • Jeffrey Niezgoda, Kent Imaging Inc.

    CMO Wound & Vascular, Kent Imaging Inc., Calgary, Canada

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Published

2025-05-31

Issue

Vol. 1 No. 1 (2025): Current Volume

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Articles

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How to Cite

The plantar-palmar index with near infrared spectroscopy as an alternative to the ankle-brachial index for non-invasive evaluation of vascular perfusion and peripheral arterial disease. (2025). International Journal of Tissue Repair, 1(1). https://doi.org/10.63676/m0ww6304