Quantification of residual limb skeletal muscle perfusion with contrast-enhanced ultrasound during application of a focal junctional tourniquet

Brian P. Davidson, J. Todd Belcik, Brian H. Mott, Gregory Landry, Jonathan Lindner

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    12 Scopus citations

    Abstract

    Objective Focal junctional tourniquets (JTs) have been developed to control hemorrhage from proximal limb injuries. These devices may permit greater collateral perfusion than circumferential tourniquets. We hypothesized that JTs eliminate large-vessel pulse pressure yet allow a small amount of residual limb perfusion that could be useful for maintaining tissue viability. Methods Ten healthy control subjects were studied. Transthoracic echocardiography, Doppler ultrasound of the femoral artery (FA) and posterior tibial artery, and contrast-enhanced ultrasound (CEU) perfusion imaging of the anterior thigh extensor and calf plantar flexor muscles were performed at baseline and during application of a JT over the common FA. Intramuscular arterial pulsatility index was also measured from CEU intensity variation during the cardiac cycle. Results FA flow was eliminated by JTs in all subjects; posterior tibial flow was eliminated in all but one. Perfusion measured in the thigh and calf muscles was similar at baseline (0.33 ± 0.29 vs 0.29 ± 0.22 mL/min/g). Application of the JT resulted in a reduction of perfusion (P

    Original languageEnglish (US)
    Pages (from-to)148-153
    Number of pages6
    JournalJournal of Vascular Surgery
    Volume63
    Issue number1
    DOIs
    Publication statusPublished - Jan 1 2016

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    ASJC Scopus subject areas

    • Cardiology and Cardiovascular Medicine
    • Surgery

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