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Assess Endothelial DysfunctionPeriCam PSI / PF 5000

  • Post Occlusive Reactive Hyperemia
  • Heat controlled laser Doppler
  • Iontophoresis

The PeriFlux System 5000 is not available within the EU and the EEA.


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Endothelial Dysfunction

An increasing amount of evidence links microvascular dysfunction to cardiovascular outcomes. Endothelial dysfunction is a systemic pathologic state characterized by reduced vasodilation. The endothelium-dependent and independent vasodilation can be assessed by tests such as post occlusive reactive hyperemia, local heating and iontophoresis.

Features

Post Occlusive Reactive Hyperemia (PORH)

Post occlusive reactive hyperemia (PORH) is used to investigate and assess microvascular function (endothelial function). The test involves blood perfusion measurements before, during and after occlusion.


Features PeriFlux System 5000
Features PeriCam PSI NR
Automated control of pressures.High spatial and temporal resolution.
Programmable PORH protocolsExcellent inter-day reproducibility
Recording of hyperemic areas and response times.
Normalization of skin temperature.


 

Thermal challenge

Local heating of the skin may elicit near maximal vasodilatation. In healthy individuals the response to thermal hyperemia demonstrates a predictable pattern. It is characterized by an initial peak in skin blood perfusion, involving the sensory afferents, and a secondary rise and plateau mediated by NO release.

Features PeriFlux System 5000 Features PeriCam PSI NR
Simultaneous heating/monitoring of skin areas. Water-filled heatable ring.
Pre-set heating protocols.
Heating range: 26 – 44 ⁰C.
Heating rate: 1 ⁰C per second.

Iontophoresis

Iontophoresis is a technique to transport charged molecules or drugs across a tissue barrier. Combined with the laser Doppler or laser speckle techniques, iontophoresis is a valuable tool for diagnosis and studying endothelial dysfunction.


Features PeriFlux System 5000Features PeriCam PSI NR
Single-point monitoring.Imaging of larger area.
Low volumes of drug solution needed.Transparent drug delivery chamber.
Standardized skin temperature during experiment.Calculation of flare statistics.


Instrument versions

PeriFlux 5000 LDPM

Laser Doppler perfusion monitoring (LDPM) is a well-established technique for assessing endothelial dysfunction in skin. The PeriFlux System 5000 equipped with the function units for LDPM, heat control and pressure monitoring offers a complete set-up for the main reactivity tests used in endothelial dysfunction studies. Further, iontophoresis using the PeriIont Micropharmacology System can be applied to deliver drugs with endothelial dependent or independent vascular responses.

PeriCam PSI

The PeriCam PSI uses a non-invasive imaging solution that allows assessment of skin perfusion over wide areas (up to ~600 cm2) with up to ~100 images/s. The laser speckle imaging technique has shown excellent intra- and inter-subject reproducibility in assessments of skin endothelial function. Iontophoresis can easily be implemented with the PeriIont Micropharmacology System and its transparent drug delivery chambers.

Application examples
PORH
Iontophoresis Iontophoresis
Raynaud Raynaud

References

  1. Binggeli C. et al. Statins enhance postischemic hyperemia in the skin circulation of hypercholesterolemic patients. J Amer Collage of Card 2003 42; 1:71-77
  2. Ruano J. et al. Phenolic content of virgin olive oil improves ischemic reactive hyperemia in hypercholesterolemic patients. J Amer Collage of Card 2005 46; 10:1864-1868
  3. Roustit M. et al, Excellent reproducibility of laser speckle contrast imaging to assess skin microvascular reactivity Microvascular Research, 2010
  4. Ann Humeau-Heurtier et al. Excellent inter- and intra-observer reproducibility of microvascular tests using laser speckle contrast imaging, Clinical Hemorheology and Microcirculation, 2013
  5. Roustit et al, Assessment of endothelial and neurovascular function in human skin microcirculation,  Trends in Pharmacological Sciences, 2013, 34(7):373-84
  6. Kellogg D.L. Jr. In vivo mechanisms of cutaneous vasodilation and vasoconstriction in humans during thermoregulatory challenges. J Appl Physiol 2006;100:1709-1718.
  7. Gooding K.M. et al, Maximum Skin Hyperaemia Induced by Local Heating: Possible Mechanism. J Vasc Res 2006;43:270-277
  8. Minson C.T. et al, Nitric oxide and neurally mediated regulation of skin blood flow during local heating. J Appl Physiol 2001 91:1619-1626
  9. Minson C.T. et al, Thermal provocation to evaluate microvascular reactivity in human skin. J Appl Physiol 2010 109:1239-1246
  10. Blaauw J. et al. Abnormal endothelium-dependent microvascular reactivity in recently preeclamptic women. Amer Coll of Obstetricians and Gynecologists, 2005, 105; 3:626-632
  11. Durand S. et al. Prostaglandins participate in the late phase of the vascular response to acetylcholine iontophoresis in humans. J Physiol, 2004, 811-819
  12. Roustit et al, Assessment of endothelial and neurovascular function in human skin microcirculation. Trends in Pharmacological Sciences, 2013, 34(7):373-84.

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Improving quality of life since 1981

Perimed AB, established in 1981, provides instruments, software and expertise to enable assessment of the microcirculation. We utilize laser Doppler, laser speckle (LASCA) and transcutaneous oxygen (tcpO2 or TCOM), to accurately monitor and quantify blood perfusion and tissue oxygenation in real-time. Our modular PeriFlux System 5000 and PeriFlux 6000, the latest generation of our PeriFlux System, are excellent choices for diagnosing Peripheral Arterial Disease (PAD) and Critical Limb Ischemia (CLI) or for assessing wound healing potential in your vascular patients. Our blood perfusion imager PeriCam PSI System allows you to investigate spatial distribution, for example during cortical spreading depression.