Assessment of the Utility of a Vascular Early Warning System Device in the Assessment of Peripheral Arterial Disease in Patients with Diabetes and Incompressible Vessels

Reliability of bedside tests for diagnosing peripheral arterial disease in patients prone to medial arterial calcification: A systematic review

“… CTA (PAD was defined as >50% stenosis) Current results only include the subgroup analysis. ABI: Sens: 74·7(64-83) Spec: 88.9(57-98) PLR: 6·73 NLR: 0·28 PPG: Sens: 78·5 (68-86) Spec: 89% (57-98) PLR: 7·14 NLR: 0·24 CWD: Sens: 97·5 (91-99) Spec: 66·7 (35-88) PLR: 2·93 NLR: 0·04 Saunders et al 27 2019 United Kingdom Single-centerretrospective cohort study N = 16 patients (32 limbs) Mean age: 66 years Gender: 94% male Selection criteria included confirmed incompressible vessels (defined as persistent flow with blood pressure cuff inflated to >220 mm Hg) and MRA within the preceding 6 months with no interval arterial intervention. All patients had tissue loss Vascular early warning system (VEWS) device MRA (PAD was defined as >50% stenosis) VEWS ≤0·94: Sens: 73% Spec: 80% PLR: 3·65 NLR: 0·34 VEWS functions by using red and infrared optical sensors placed on the toe and dorsum of the foot to register changes in blood volume within the microvasculature that occur during a gravity-induced functional test.…”

“…Of the studies selected, 12 were prospective cohort or cross-sectional studies (n=3847), nine were retrospective studies (n=2837), and two were prospective case-control studies (n=185). In the 23 included studies, the number of study participants ranged from 16 27 to 2188, 28 and the ages of subjects at baseline ranged from 53 to 77 years old. The diagnosis of DM was specifically noted in 3693 patients.…”

“…described a Vascular Early Warning System device (VEWS). 27 The VEWS device functions by measuring changes in blood volume in the microvasculature of the foot, as detected by infrared optical sensors. This method showed a PLR of 3·65 and NLR 0·34 when a cut-off of ≤0·94 was selected to detect PAD.…”

The Potential Role of Sensors, Wearables and Telehealth in the Remote Management of Diabetes-Related Foot Disease

“…The benefit of these devices in improving clinical outcomes need to be further evaluated in RCTs [15,82] Legend: PAD = peripheral artery disease, RCT = randomised controlled trial, HbA1c = glycated haemoglobin A1c, DFD = diabetes-related foot disease.…”

“…There is a current Cochrane review that is reviewing the evidence of the accuracy of all potential simple tests for screening DPN to supply more comprehensive evidence [ 83 ]. There is also interest in the development of sensors to determine foot perfusion [ 15 ]; the vascular early warning system (VEWS), for example, functions by using infrared optical sensors placed on the toe and dorsum of the foot to measure changes in blood volume within the microvasculature during foot elevation [ 15 ]. These sensors have not been tested in well-powered randomissed clinical trials or in comparison to standard care [ 84 ].…”