Limb loss is one of the deadliest complications of diabetes, chronic kidney disease, and peripheral arterial disease.

Diabetes, chronic kidney disease, and peripheral arterial disease are associated with microvascular dysfunction, leading to foot ulcerations and amputations. These complications pose a considerable cost burden to health care systems around the world. A foot ulcer precedes 85% of amputations (Edmonds et al., 2021), but they are preventable with early identification, timely referral to specialists, and targeted intervention. One pervasive challenge for clinicians is that there is no easy to use and readily available technology to help them risk-stratify and identify these patients.

The microvascular system is a barometer of vascular and tissue health.

The microvascular system is essential for establishing and maintaining tissue health and vascular function via oxygenation and perfusion. Silent, slow changes to these small blood vessels are accelerated with aging, chronic disease, an macrovascular disease, impacting the body’s ability to deliver oxygen to the tissue.

The presence of microvascular disease:

Accounts for 18% of all amputations (Behroozian et al., 2020)
Increases the risk of amputation 4-fold (Beckman et al., 2019)
Increases the risk of amputation 20-fold with the presence of PAD (Beckman et al., 2019)
Increases the risk of amputation for patients with or without diabetes (Beckman et al., 2019)

Current noninvasive vascular exams only assess large vessels even though microvascular disease (MVD) is a recognized risk factor for poor wound healing, diabetic foot ulcers (DFU), and amputations. The microvascular system is an excellent barometer for monitoring macrovascular, microvascular, and tissue health.

“Clinical evidence of MVD diagnosed in any vascular bed increases the risk for dermal microvascular dysfunction, poor wound healing, and amputation.”

Dr. Joshua Beckman, MD, MS, Director, Vascular Medicine, Professor of Medicine, Vanderbilt University Medical Center

Until now, there was no way to assess the microvascular system at the point-of-care.