Piezoelectric pulse sensor device (Pulse Chek)-monitoring after the treatment of lower leg ischemia.
BACKGROUND
The aim of this study was to evaluate the usefulness of the piezoelectric pulse sensor device (Pulse Chek) as a continuous monitoring method in early surveillance after the treatment of lower leg ischemia with either surgical or interventional procedures.


METHODS



METHODS
prospective study.


METHODS
institutional practice.


METHODS
two patient groups with peripheral arterial occlusive disease were included; a surgical group undergoing femoropopliteal bypass grafting (22 patients) and a group undergoing PTA of the femoral or popliteal arteries (18 patients).


METHODS
the piezoelectric pulse sensor was applied on the skin over the dorsalis pedis artery. A baseline waveform was recorded preoperatively and continuous monitoring begun immediately after the surgical or interventional procedure. Hard copy recordings of the pulse wave were done in the immediate postoperative period, the postoperative evening, the following morning or at any time the alarm was triggered. A late follow-up waveform was recorded after an average of 34 days. Simultaneous ABI measurements were recorded.


RESULTS
Preoperatively or pre-intervention, the pulse waveform was accurately recorded in 15/22 (68%) patients in the surgical group and 14/18 (78%) patients of the PTA group. In 20 (91%) surgical group patients and in 14 (78%) PTA group patients, postoperative monitoring was reliable, the pulse waveform confirmed patency of the vessel. Piezoelectric pulse sensor device monitoring did not detect graft occlusion in only one patient in the surgical group where interpretation of the pulse wave was complicated by a slow atrial fibrillation. There were 19 alarms in the pulse waveform during monitoring for 11 (55%) surgical group patients and 18 alarms for 9 (64%) PTA group patients. None of the alarms resulted from graft occlusion. Reliable pulse waveform recordings were obtained in 16/21 (76%) surgical group patients of the original 22 (one graft occluded) and for 15/18 (83%) PTA group patients in the follow-up assessment after the mean 34 days. One surgical patient was lost to follow-up.


CONCLUSIONS
The piezoelectric pulse sensor device can be recommended as a method of continuous monitoring immediately after the revascularization procedure in those patients who have a pedal artery where a reliable pulse waveform can be recorded.
Department of Surgery, University Hospital, Tampere, Finland.
T
T
Laine
R
R
Zeitlin
J P
JP
Salenius
D000368:Aged; D000369:Aged, 80 and over; D001157:Arterial Occlusive Diseases / Q000150:complications / Q000503:physiopathology* / Q000601:surgery; D004867:Equipment Design; D005260:Female; D005263:Femoral Artery / Q000503:physiopathology / Q000601:surgery; D006801:Humans; D007511:Ischemia / Q000209:etiology / Q000503:physiopathology* / Q000601:surgery; D007866:Leg / Q000098:blood supply*; D008297:Male; D008875:Middle Aged; D011150:Popliteal Artery / Q000503:physiopathology / Q000601:surgery; D011182:Postoperative Care / Q000379:methods; D011446:Prospective Studies; D011674:Pulse / Q000295:instrumentation*; D015203:Reproducibility of Results