Evaluation of feasibility of ankle pressure and foot oximetry values for the detection of critical limb ischemia in diabetic patients.
A total of 261 diabetic patients were admitted because of rest pain and/or foot ulcer in 1 limb. Ankle pressure (AP) and transcutaneous oxygen tension (TcPO(2)) were measured, and digital subtraction arteriography was performed. Transcutaneous oxygen tension was <30 mm Hg in 213 patients and >or=30<50 mm Hg in 48 patients. Ankle pressure could not be measured in 109 patients. In 50 patients, AP was <70 mm Hg and in 102 patients, it was >or=70 mm Hg. Arteriography showed evidence of stenoses >50% of vessel lumen diameter in all patients. Major amputation was performed in 16 patients; AP was <70 mm Hg in 4 patients and >or=70 mm Hg in 6. It was not practicable in the remaining 6 patients. Transcutaneous oxygen tension was <30 mm Hg in 15 patients and >or=30 mm Hg in 1 patient. For diagnosis of critical limb ischemia (CLI) in diabetic patients presenting with rest pain or foot ulcer, measurement of TcPO( 2) is essential not only when AP is not measurable but also when this value is >or=70 mm Hg.
Faglia
Ezio
E
Diabetic Foot Centre-IRCCS Multimedica, Sesto San Giovanni, Milan, Italy.
Ezio
Faglia
F
Clerici
Giacomo
G
Giacomo
Clerici
C
Caminiti
Maurizio
M
Maurizio
Caminiti
C
Quarantiello
Antonella
A
Antonella
Quarantiello
Q
Curci
Vincenzo
V
Vincenzo
Curci
C
Somalvico
Francesco
F
Francesco
Somalvico
S
D000368:Aged; D000369:Aged, 80 and over; D000671:Amputation, Surgical; D015901:Angiography, Digital Subtraction; D000800:Angioplasty, Balloon; D000842:Ankle / Q000098:blood supply*; D001794:Blood Pressure; D001795:Blood Pressure Determination / Q000295:instrumentation / Q000379:methods*; D016638:Critical Illness; D017719:Diabetic Foot / Q000097:blood / Q000175:diagnosis* / Q000503:physiopathology / Q000628:therapy; D005240:Feasibility Studies; D005260:Female; D005528:Foot; D006801:Humans; D007511:Ischemia / Q000097:blood / Q000175:diagnosis* / Q000503:physiopathology / Q000628:therapy; D023821:Limb Salvage; D008297:Male; D008875:Middle Aged; D010092:Oximetry; D010146:Pain / Q000175:diagnosis; D010147:Pain Measurement; D011237:Predictive Value of Tests; D012867:Skin / Q000098:blood supply*; D019722:Sphygmomanometers; D016896:Treatment Outcome; D018608:Ultrasonography, Doppler; D014656:Vascular Surgical Procedures