Evaluation of lower limb arteries with Doppler ultrasound in patients with ulcers before and after hyperbaric oxygen therapy: An experimental single cohort study

Objective To evaluate the effects of hyperbaric oxygen therapy (HBOT) on the arterial hemodynamics of the lower limbs using duplex ultrasound in patients with ulcers and to assess the correlation between hemodynamic changes and clinical outcomes. Methods This was a pre-post intervention study including 28 patients with lower limb ulcers who underwent a standardized HBOT protocol. Hemodynamic assessments were performed by duplex ultrasound before and after treatment, measuring peak systolic velocity (PSV), end-diastolic velocity (EDV), and flow volume (FV) in the common femoral and popliteal arteries. Results The mean age of the participants was 65.2 years, with 64.3% being male. No statistically significant differences were observed in hemodynamic parameters after HBOT. For the common femoral artery, PSV (cm/s) showed an increase of 2.4 (115 vs. 117.4; MD 2.4; p = 0.764), EDV (cm/s) increased by 2.3 (12.8 vs. 15.1; MD 2.3; p = 0.423), and Flow Volume (ml/s) increased by 76 (1847 vs. 1923; MD 76; p = 0.291). For the popliteal artery, PSV (cm/s) showed a reduction of 1.6 (76.4 vs. 74.8; MD -1.6; p = 0.635), EDV (cm/s) increased by 0.5 (8.3 vs. 8.8; MD 0.5; p = 0.555), and FV (ml/s) decreased by 60 (718 vs. 658; MD -60; p = 0.111). Conclusion HBOT does not modify macrovascular hemodynamic parameters of the lower limbs in patients with ulcers. These findings suggest that the clinical benefits of HBOT may be primarily mediated by microvascular and cellular mechanisms, rather than alterations in macrovascular flow.