Transcutaneous oxygen pressure measurements (tcpO2) at ankle during exercise in arterial claudication.
OBJECTIVE
Although a time consuming technique, tcpO2 provides complementary information as compared to other tests. Simultaneous recording of systemic and peripheral oxygen pressure changes with exercise could be interesting to confirm that local hypoxemia is of arterial origin, but accuracy versus gold standard arteriography and objectively determined cut-off points to be used in arterial claudication at the ankle are not reported.


METHODS



METHODS
retrospective plus prospective study.


METHODS
institutional practice, ambulatory care.


METHODS
100 patients suffering stage 2 claudication (group A) were retrospectively studied to objectively define cut-off points derived from tcpO2 recordings to be used in exercise testing. Then, applicability and reproducibility of these cut-off points were analysed prospectively in another 50 patients (group B).


METHODS
tcpO2 was measured on both calves and with a chest reference electrode. Arteriography on each side was quoted positive for a diameter stenosis superior to 75% or occlusion on the aorto-popliteal axis or of all-3-calf arteries.


RESULTS
The best performance was obtained with tcpO2 changes from rest at the calf normalised to eventual chest changes (DROP) during or following the treadmill test. Optimal cut-off point determined through ROC curve analysis for DROP was -15 mmHg in group A. Applying this cut-off point in group B provided a 86/84% sensitivity/specificity and showed excellent reproducibility.


CONCLUSIONS
TcpO2 measurement on the calf during exercise could be useful in a selected population of patients with claudication of questionable vascular origin and/or when other non-invasive investigations cannot be performed.
Abraham
P
P
Department of Vascular Investigations, University Hospital, Angers, France. piabraham@chu-angers.fr
Picquet
J
J
Bouyé
P
P
L'Hoste
P
P
Enon
B
B
Vielle
B
B
Saumet
J L
JL
D000368:Aged; D000842:Ankle / Q000502:physiology*; D001785:Blood Gas Monitoring, Transcutaneous; D015444:Exercise / Q000502:physiology*; D005260:Female; D006801:Humans; D007383:Intermittent Claudication / Q000097:blood* / Q000503:physiopathology; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D010991:Plethysmography; D011446:Prospective Studies; D012372:ROC Curve; D012189:Retrospective Studies; D012680:Sensitivity and Specificity