The Novel use of Infrared Thermal Imaging as an Adjunct for the Management of Haemodialysis Access Induced Distal Ischaemia

Shakarchi, Julien Al; Mellor, Steve; Inston, Nicholas

doi:10.5301/jva.5000524

Cited by 4 publications

(3 citation statements)

References 9 publications

(11 reference statements)

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“…Furthermore, the human skin with an emissivity value of 0.98, is a near‐ideal radiator in the infrared domain 16 . In this regard, there is emerging literature on the utility of IRT for detection of peripheral arterial disease (PAD), deep vein thrombosis (DVT), diabetic vasculopathy and neuropathy, posttraumatic acute compartment syndrome, and other vascular diseases 20,23–33 . Multiple studies have also demonstrated a good correlation between IRT and other established diagnostic tools, such as ankle‐brachial index for diagnosis of PAD and Doppler ultrasound for DVT.…”

Section: Discussionmentioning

confidence: 99%

Infrared thermography as an adjunctive tool for detection of femoral arterial thrombosis after cardiac catheterization: A prospective, pilot study

Kang

Manojlovich

Mrozcek

et al. 2022

Cathet Cardio Intervent

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Objectives: To assess the utility of infrared thermography (IRT), to map skin temperature, in the detection of femoral arterial (FA) thrombosis after cardiac catheterization.Background: Ultrasound is a validated method for thrombus detection but is generally reserved as a confirmatory test for clinical suspicion due to various constraints.Methods: Prospective study of infants and children undergoing cardiac catheterization via FA access, comparing IRT and pulse examination. The thermograms, displayed in a color map with each pixel representing a temperature, were examined by qualitative assessment of symmetry in thermal patterns and quantitative image analysis with abnormal thermographic asymmetry defined as a difference of >10% between limbs. Results:In the 20 children enrolled, excellent agreement was found between the two methods with a Kappa value of 0.89. The median thermographic asymmetry in the nine children with pulse loss was 36 (13-76)%. Using receiver operating characteristic analysis, the asymmetrical pattern of ≥18% between limbs predicted the need for anticoagulation with a sensitivity of 100% and specificity of 89%. The area under the curve was 0.97 (95% confidence interval: 0.95-1). Children with absent pulse requiring anticoagulation showed a slower recovery in thermal asymmetry compared to those with a reduced pulse. By qualitative IRT assessment, all children with absent pulse requiring anticoagulation were correctly identified by 10 independent assessors.Conclusions: This pilot study showed that IRT is feasible and reliable as an adjunctive tool for thrombus detection postcatheterization and treatment monitoring. Specific advantages of IRT include portability, affordability, and contactless image acquisition.

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Section: Discussionmentioning

confidence: 99%

Infrared thermography as an adjunctive tool for detection of femoral arterial thrombosis after cardiac catheterization: A prospective, pilot study

Kang

Manojlovich

Mrozcek

et al. 2022

Cathet Cardio Intervent

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“…As decreased temperature is a common symptom, quantification using novel techniques such as infrared thermography may have some use although this is still experimental (44).…”

Section: Investigationmentioning

confidence: 99%

Arteriovenous access ischemic steal (AVAIS) in haemodialysis: a consensus from the Charing Cross Vascular Access Masterclass 2016

et al. 2016

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Arteriovenous access ischaemic steal (AVAIS) is a serious and not infrequent complication of vascular access. Pathophysiology is key to diagnosis, investigation and management. Ischaemia distal to an AV access is due to multiple factors. Clinical steal is not simply blood diversion but pressure changes within the adapted vasculature with distal hypoperfusion and resultant poor perfusion pressures in the distal extremity. Reversal of flow within the artery distal to the AV access may be seen but this is not associated with ischaemia in most cases.Terminology is varied and it is suggested that arteriovenous access ischemic steal (AVAIS) is the preferred term. In all cases AVAIS should be carefully classified on clinical symptoms as these determine management options and allow standardisation for studies.Diabetes and peripheral arterial occlusive disease are risk factors but a 'high risk patient' profile is not clear and definitive vascular access should not be automatically avoided in these patient groups.Multiple treatment modalities have been described and their use should be directed by appropriate assessment, investigation and treatment of the underlying pathophysiology. Comparison of treatment options is difficult as published studies are heavily biased. Whilst no single technique is suitable for all cases of AVAIS there are some that suit particular scenarios and mild AVAIS may benefit from observation whilst more severe steal mandates surgical intervention.

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“…We agree with the authors that it would be interesting to follow-up patients with infrared thermal imaging over the course of the maturation process and we are planning to do this in a future study. Regarding arteriovenous access-induced ischaemia, we have already published a paper on the use of infrared thermal imaging as an adjunct for the management of this condition (3).…”

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confidence: 99%

Reply to Comments on: Novel use of infrared thermal imaging to predict arteriovenous fistula patency and maturation

Shakarchi

Inston

2018

J Vasc Access

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We thank Hopkins and Khalid for their letter to the editor (1) concerning our recently published study on the novel use of infrared thermal imaging to predict arteriovenous fistula patency and maturation (2). We agree with the comments made regarding early surgical intervention. We do not suggest that patients found without a fall in temperature should be taken back to theatre. We propose that they should be monitored closely to allow early radiological intervention to assist maturation, or to plan further vascular access formation. We agree with the authors that it would be interesting to follow-up patients with infrared thermal imaging over the course of the maturation process and we are planning to do this in a future study. Regarding arteriovenous access-induced ischaemia, we have already published a paper on the use of infrared thermal imaging as an adjunct for the management of this condition (3). Disclosures Financial support: No grants or funding have been received for this study.

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The Novel use of Infrared Thermal Imaging as an Adjunct for the Management of Haemodialysis Access Induced Distal Ischaemia

Abstract: This small case series reports on the successful use of infrared thermal imaging in the diagnosis and management of possible HAIDI and may support wider study and use.

Cited by 4 publications

References 9 publications

Infrared thermography as an adjunctive tool for detection of femoral arterial thrombosis after cardiac catheterization: A prospective, pilot study

Infrared thermography as an adjunctive tool for detection of femoral arterial thrombosis after cardiac catheterization: A prospective, pilot study

Arteriovenous access ischemic steal (AVAIS) in haemodialysis: a consensus from the Charing Cross Vascular Access Masterclass 2016

Reply to Comments on: Novel use of infrared thermal imaging to predict arteriovenous fistula patency and maturation

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