title: Prognostic significance of distal blood pressure measurements in patients with severe ischaemia.
abstract: The clinical course was followed and the ankle and toe blood pressures were measured with the strain gauge technique on 5 occasions during 2 years in 43 patients with pain at rest and/or ischaemic ulceration due to severe ischaemia of the legs on the basis of occlusive arterial disease. Although arteriosclerosis of the legs in non-diabetic patients is generally considered a benign disease from the standpoint of limb survival, the critical level of TPI (systolic toe blood pressure/systolic arm blood pressure) was found to be 0.07 as a TPI below this value was associated with an overall 82% risk of amputation. With TPI above 0.07, the chance of successful conservative therapy was about 40%. Diabetics with severe ischaemia must be regarded as a high risk group in respect of amputation (64%) and lethality (64%). A variance analysis was made on the pressure data: In patients with low pressure peripheral vascular beds, the TPI must change more than 0.15 units from one examination to another before the alteration can be considered significant at the 99% confidence level.
mesh_terms: D000368:Aged; D000671:Amputation, Surgical; D001794:Blood Pressure; D001795:Blood Pressure Determination / Q000379:methods; D003925:Diabetic Angiopathies / Q000401:mortality / Q000503:physiopathology / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007383:Intermittent Claudication / Q000401:mortality / Q000503:physiopathology* / Q000601:surgery; D007511:Ischemia; D007866:Leg / Q000098:blood supply / Q000601:surgery; D008297:Male; D008875:Middle Aged; D011379:Prognosis