Evaluating hemodynamic response to treatment in patients with peripheral arterial disease using dynamic vascular optical spectroscopy.

Significance: Tracking changes in the vasculature of patients with peripheral arterial disease (PAD) may identify the need for follow-up treatment within only weeks after an initial intervention, enabling timely support and improving patient outcomes.

Aim: We aim to evaluate dynamic vascular optical spectroscopy's (DVOS's) ability to accurately monitor the hemodynamics of affected arteries in patients with PAD after a surgical intervention and predict long-term clinical outcomes.

Approach: A DVOS system non-invasively monitored the blood flow through 256 lower extremity arteries in 80 PAD patients immediately before, immediately after, and 3 to 4 weeks after they underwent a surgical intervention.

Results: Hemodynamic changes measured by DVOS after a revascularization procedure (RP) classified patient long-term ( $6.2\pm 4.4$ months) outcomes with high accuracy [81.6% for patients with ulcers ( $n=31$ ); 81.1% for patients without ulcers ( $n=54$ )] by 3 to 4 weeks after the RP, outperforming available ankle-brachial index and ultrasound measurements. In addition, DVOS parameters distinguished between patients who underwent only a catheter angiography (CA) and patients who underwent both a CA and RP ( $P<0.05$ ).

Conclusions: The DVOS system was able to classify patient long-term clinical outcomes with high accuracy within one month after an RP and distinguish among different interventions. DVOS may be a promising alternative or adjunct to existing monitoring approaches.