Hand Acceleration Time Assessment With Ultrasound Doppler

NCT05977725 | Unknown

• 1 other identifier: 1 - VASC - 2023
• Study Type: observational
• Target: 35
• Locations: 1 country
• Sites: 1

Brief Summary

Chronic upper limb ischemia syndrome is uncommon compared to lower limb ischemia, with several potential causes (e.g., arteriosclerosis, compressive syndromes, arteritis, connective tissue diseases, trauma, and thrombosis). Many patients with upper limb ischemia remain asymptomatic due to arterial collateral vascularization. Given the wide variety of potential causes for upper limb ischemia, the diagnosis may require different technical approaches. Doppler ultrasound is a non-invasive, accessible, non-radiating technique that provides direct arterial imaging, yielding valuable information on arterial anatomy and hemodynamics. Some authors have described the reliability of the arterial duplex ultrasound for lower limb assessment using the pedal acceleration time (PAT). The PAT provides real-time hemodynamic physiological information on the entire limb. The acceleration time (AT) is an ultrasound parameter which measures the time elapsed (in milliseconds, ms) from the beginning of the arterial Doppler waveform until the systolic peak, evaluating the morphology of the arterial waveform in real time. In a healthy individual, this time should be short (between 40 - 100 milliseconds), displaying a triphasic waveform with a systolic acceleration, a sudden diastolic fall, and a subsequent anterograde flow at the end of diastole. A more damped wave suggests proximal stenosis and the acceleration time has been correlated to different degrees of foot ischemia. Notably, the AT parameter has also been studied in other territories, such as the carotid and pulmonary arteries, coronary arteries, and the aorta. Hand acceleration time (HAT) has also been described very recently as a potential tool to assess hemodialysis access-induced ischemia, cardiogenic shock, and subclavian iatrogenic ischemic lesion. However, the HAT has not yet been properly characterized or validated. Our working hypothesis is that the HAT is a useful diagnostic tool for chronic upper limb ischemia.

Conditions

Upper Limb Ischemia; Vascular Disease

Keywords

Hand acceleration time; Upper limb ischemia; Vascular disease

Outcome Measures

Primary Outcomes (1)

• Median (range) hand acceleration time measured by Doppler ultrasound

  The hand acceleration time will be measured at the following arteries: * Distal radial artery * Distal ulnar artery * Princeps pollicis artery * Index finger radial artery * Second common palmar digital artery * Fourth common palmar digital artery

  Day 1

Secondary Outcomes (5)

• Median (range) age of the participants.

  Day 1

• Number (percentage) of male/female participants.

  Day 1

• Number (percentage) of patients presenting cardiovascular risk factors of interest.

  Day 1

• Number (percentage) of patients with past medical history of interest.

  Day 1

• Presence (Yes/No) of distal pulses in the upper limb.

  Day 1

Study Arms (2)

Healthy Volunteers

Lack of upper limb arterial disease.

Diagnostic Test: Hand Doppler Ultrasound

Patients with Chronic Upper Limb Ischemia

Known diagnosis of chronic upper limb ischemia.

Diagnostic Test: Hand Doppler Ultrasound

Interventions

Hand Doppler Ultrasound DIAGNOSTIC_TEST

Hand Doppler Ultrasound to assess the Hand Acceleration Time (HAT)

Healthy Volunteers; Patients with Chronic Upper Limb Ischemia

Eligibility Criteria

• Age: 18 Years+
• Sex: all
• Healthy Volunteers: Yes
• Age Groups: Adult (18-64), Older Adult (65+)
• Sampling Method: Non-Probability Sample

Study Population

The study population will consist of healthy volunteers accompanying patients to the Angiology and Vascular Surgery outpatient clinic visit and patients diagnosed with chronic upper limb ischemia. Both will be required to sign the written informed consent before joining the study.

You may qualify if:

• Healthy adult volunteers (≥ 18 years of age).
• No evidence of upper limb arterial disease.
• Who sign the written informed consent.

You may not qualify if:

• Healthy volunteers unable (at the investigator discretion) to understand or comply with any study-related procedure.
• Healthy volunteers who refuse to participate.
• Those presenting cardiovascular risk factors (e.g., hypertension, diabetes mellitus, dyslipidemia).
• Adult patients (≥ 18 years of age) with a known diagnosis of chronic upper limb ischemia.
• Who sign the written informed consent.
• Patients unable (at the investigator discretion) to understand or comply with any study-related procedure.
• Patients who refuse to participate.

Sponsors & Collaborators

• Hospital Universitari de Bellvitge: lead

Study Sites (1)

Hospital Universitari de Bellvitge

L'Hospitalet de Llobregat, Barcelona, 08907, Spain

Location

Related Publications (7)

• Sommerset J, Karmy-Jones R, Dally M, Feliciano B, Vea Y, Teso D. Plantar Acceleration Time: A Novel Technique to Evaluate Arterial Flow to the Foot. Ann Vasc Surg. 2019 Oct;60:308-314. doi: 10.1016/j.avsg.2019.03.002. Epub 2019 May 8.

  PMID: 31075481 BACKGROUND

• Teso D, Sommerset J, Dally M, Feliciano B, Vea Y, Jones RK. Pedal Acceleration Time (PAT): A Novel Predictor of Limb Salvage. Ann Vasc Surg. 2021 Aug;75:189-193. doi: 10.1016/j.avsg.2021.02.038. Epub 2021 Apr 3.

  PMID: 33823258 BACKGROUND

• Strosberg DS, Haurani MJ, Satiani B, Go MR. Common carotid artery end-diastolic velocity and acceleration time can predict degree of internal carotid artery stenosis. J Vasc Surg. 2017 Jul;66(1):226-231. doi: 10.1016/j.jvs.2017.01.041. Epub 2017 Apr 5.

  PMID: 28390773 BACKGROUND

• Wang S, Wang Y, Gao M, Tan Y. Acceleration time to Ejection time ratio in fetal pulmonary artery system can predict neonatal respiratory disorders in gestational diabetic mellitus women. Clin Hemorheol Microcirc. 2022;80(4):497-507. doi: 10.3233/CH-211265.

  PMID: 34924370 BACKGROUND

• Takemoto K, Hirata K, Wada N, Shiono Y, Komukai K, Tanimoto T, Ino Y, Kitabata H, Takarada S, Nakamura N, Kubo T, Tanaka A, Imanishi T, Akasaka T. Acceleration time of systolic coronary flow velocity to diagnose coronary stenosis in patients with microvascular dysfunction. J Am Soc Echocardiogr. 2014 Feb;27(2):200-7. doi: 10.1016/j.echo.2013.10.013. Epub 2013 Dec 15.

  PMID: 24345631 BACKGROUND

• Zarzecki MP, Popieluszko P, Zayachkowski A, Pekala PA, Henry BM, Tomaszewski KA. The surgical anatomy of the superficial and deep palmar arches: A Meta-analysis. J Plast Reconstr Aesthet Surg. 2018 Nov;71(11):1577-1592. doi: 10.1016/j.bjps.2018.08.014. Epub 2018 Aug 24.

  PMID: 30245020 BACKGROUND

• Gonzalo B, Videla S, Moranas J, Carnaval T, Herranz C, Espinar E, Iborra E. Hemodynamic Assessment of Arterial Perfusion by Using the Ultrasonographic Hand Acceleration Time: Protocol for a Cross-Sectional Prospective Descriptive Study. JMIR Res Protoc. 2025 Aug 21;14:e64450. doi: 10.2196/64450.

  PMID: 40839871 DERIVED

MeSH Terms

Conditions

Vascular Diseases

Condition Hierarchy (Ancestors)

Cardiovascular Diseases

Study Design

• Study Type: observational
• Observational Model: OTHER
• Time Perspective: PROSPECTIVE
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Expert Vascular Surgeon

Study Record Dates

• First Submitted: July 28, 2023
• First Posted: August 4, 2023
• Study Start: June 1, 2023
• Primary Completion: September 30, 2023
• Study Completion: April 30, 2024
• Last Updated: January 11, 2024

Record last verified: 2024-01

Locations

ES (1)