Regions of arterial stenosis and clinical factors determining transcutaneous oxygen tension in patients with peripheral arterial disease.
OBJECTIVE
Despite the clinical usefulness of transcutaneous oxygen tension (TcPO(2)) to assess the severity of limb ischemia, the factors determining TcPO(2) in patients with peripheral arterial disease (PAD) have not been fully clarified. We therefore examined the regions of arterial stenosis and clinical factors affecting lower-extremity TcPO(2).


METHODS
Resting TcPO(2) (REST-TcPO(2)) and postexercise TcPO(2) (Ex-TcPO(2)) in the calf region and the dorsalis pedis were measured simultaneously in 66 patients (132 limbs) with clinically suspected PAD, in whom angiography was also performed.


RESULTS
The peripheral arteries of the lower extremities were divided into five segments, and the impact of significant stenosis in each segment on ipsilateral TcPO(2) was evaluated by multiple regression analysis. In the calf region, significant stenosis of the proximal arteries (common-external iliac artery) revealed stronger involvement determining Ex-TcPO(2) than the peripheral segment (posterior tibial artery). In the dorsalis pedis, the peripheral segment (anterior tibial artery) more strongly determined Ex-TcPO(2) and REST-TcPO(2) than proximal segments. Age, creatinine, and diabetes were associated with REST-TcPO(2) of the calf region independent of arterial stenoses, while those of the dorsalis pedis were independently associated with age, and creatinine. In contrast, Ex-TcPO(2) in both regions was not independently associated with clinical factors, except for stenosis of the perfusing arteries.


CONCLUSIONS
The vascular lesions affecting TcPO(2) differ between the calf region (proximal > peripheral) and the dorsalis pedis (proximal < peripheral). In addition postexercise TcPO(2) is solely determined by stenosis of the perfusing arteries, while TcPO(2) at rest is affected by multiple clinical factors.
Ueno
Hiroki
H
Metabolism, Endocrinology, and Molecular Medicine, Osaka City University Graduate School of Medicine, Osaka, Japan.
Fukumoto
Shinya
S
Koyama
Hidenori
H
Tanaka
Shinji
S
Maeno
Takaaki
T
Murayama
Masahiro
M
Otsuka
Yoshiko
Y
Mima
Yohei
Y
Kawaguchi
Yuji
Y
Shoji
Tetsuo
T
Inaba
Masaaki
M
Nishizawa
Yoshiki
Y
D001157:Arterial Occlusive Diseases / Q000503:physiopathology*; D001785:Blood Gas Monitoring, Transcutaneous; D017023:Coronary Angiography; D005260:Female; D006801:Humans; D007866:Leg / Q000098:blood supply*; D035002:Lower Extremity / Q000098:blood supply*; D008297:Male; D008875:Middle Aged; D010100:Oxygen / Q000097:blood*; D016491:Peripheral Vascular Diseases / Q000503:physiopathology*
D010100:Oxygen