Study of the Reproducibility of Laser Measurement in the Detection of Digital Obstructive Arterial Disease (DOAD)

Study Overview
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Brief Summary
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At the digital level, the diagnosis of obstructive arteriopathy is very difficult in the absence of ulcer or of true ischemic signs, and the arteriography, which is an examination to inject an intra-arterial contrast agent, is the reference measure. The measure by Laser Doppler uses a monochromatic light (laser) to measure the concentration as well as the speed of travel of red blood cells in the skin and deduct the cutaneous blood flow. The great advantage of this technique is that it is non-invasive, inexpensive and can be performed during a consultation. The patient can therefore be briefly informed of the benign (functional) or organic origin of his disorders.

Detailed Description
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In the systematic sclérodermie, 15 to 25 % of the patients suffer from active digital ulcers and 35 to 50 % of the patients will make a digital ulcer. These digital ulcers are in touch with an obstructive digital arteriopathy, that is arterial hurts modifying the arterial flow. It thus seems interesting to have diagnostic tools allowing to make the diagnosis in particular upstream to the appearance of ulcers. At present, the digital pressures can be used. At the digital level, the diagnosis of obstructive arteriopathy is very difficult in the absence of ulcer or of true ischemic signs, and the arteriography, which is an examination to inject an intra-arterial contrast agent, is the reference measure. For this study, the investigator shall use the Laser doppler PeriFlux 5000 system (Perimed, Jarfalla, Sweden - List IIa) who is regularly used in clinical routine and who has a marking IT for the recording of the blood flow at the cutaneous level for the measures of blood pressure in particular (measures of pressures in the big toe and in the fingers). The measure by Laser Doppler uses a monochromatic light (laser) to measure the concentration as well as the speed of travel of red blood cells in the skin and deduct the cutaneous blood flow. This material is used in this project because the investigators have already highlighted with this one that the detection of an obstructive digital arteriopathy was excellent. Given the invasive and costly nature of arteriography, it is only very rarely performed. Moreover, this can not be carried out during a simple consultation. Nevertheless, it is important for the patient and the practitioner to determine whether the digital symptoms are related to benign vasomotor phenomena or to a real digital arterial disease. The therapeutic management is different.

Official Title
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Study of the Reproducibility of Laser Measurement in the Detection of Digital

Conditions
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Vascular Diseases

Intervention / Treatment
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* Device: Laser Doppler
* Device: Laser speckle
* Behavioral: pain evaluation
* Other: Blood pressure and heart rate


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Patients : Adult 18 years of age or older; Woman of childbearing age under effective contraception for 1 month (IUD, pill, implant); Presenting scleroderma; Able to understand the objectives of the study and its constraints; Affiliated to social security; Having given free, informed and written consent Healthy volunteers: Adult 18 years of age or older; Woman of childbearing age under effective contraception for 1 month (IUD, pill, implant); Not presenting and showing no Raynaud syndrome and / or digital ulceration; Able to understand the objectives of the study and its constraints; Affiliated to social security; Having given free, informed and written consent Exclusion Criteria for healthy volunteers and patients subjects in periods of exclusion relating to another biomedical study; subjects with declared pregnancy; breastfeeding patients having an allergy to adhesives; protected majorities (safeguard of justice, curatorship, guardianship) and persons deprived of their liberty hospitalized in a health or social institution for any reason other than research

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Diagnostic
Allocation: Non-Randomized
Intervention Model: Parallel Assignment
Interventional Model Description: Monocentric, prospective, non-randomized study 11 healthy volonteer 33 patients
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Patients with scleroderma and potential arterial disease<br>The patients (33) will undergo a medical examination in order to analyse their medical history, parameters and check inclusion and non-inclusion criterions. Then will be performed : Visit 1 : Biology report * (* Biological evaluation carried out in all healthy subjects and in subjects whose biological check-up dates more than 2 years,+ urinary pregnancy test (if applicable)) Laser measurements at the forearm (with laser speckle) Laser measurements at the level of each finger Pain evaluation (EVA) Measurement of blood pressure and heart rate Environmental measures and skin temperature Visit 2 : Laser measurements at the level of each finger Pain evaluation (EVA) Measurement of blood pressure and heart rate Environmental measures and skin temperature | Device: Laser Doppler<br>* - Laser measurements at the level of each finger at 47 °C and at ambient temperature<br>Device: Laser speckle<br>* - Laser measurements at the forearm<br>Behavioral: pain evaluation<br>* Visual scale assesment pain<br>Other: Blood pressure and heart rate<br>* Measurement of blood pressure and heart rate<br>|
| Experimental: Healthy volunteers<br>The healthy volunteers (11) will undergo : Visit 1 : Biology report (+ urinary pregnancy test (if applicable)) Laser measurements at the forearm (with laser speckle) Laser measurements at the level of each finger Pain evaluation (EVA) Measurement of blood pressure and heart rate Environmental measures and skin temperature Visit 2 : Laser measurements at the level of each finger Pain evaluation (EVA) Measurement of blood pressure and heart rate Environmental measures and skin temperature | Device: Laser Doppler<br>* - Laser measurements at the level of each finger at 47 °C and at ambient temperature<br>Device: Laser speckle<br>* - Laser measurements at the forearm<br>Behavioral: pain evaluation<br>* Visual scale assesment pain<br>Other: Blood pressure and heart rate<br>* Measurement of blood pressure and heart rate<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Reproducibility | Change of Doppler laser measurement in subjects with scleroderma. | Change between baseline and day 15 measure | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Blood flow signal characteristics | To study changes in the signature of the blood flow signal between healthy subjects and subjects with scleroderma. | Change between baseline and day 15 measure | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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digital obstructive arterial disease, DOAD