Increased transcutaneous oxygen pressure is an indicator of revascularization after peripheral transluminal angioplasty.
BACKGROUND
In recent years, the use of peripheral transluminal angioplasty (PTA) procedures for revascularization of an ischemic limb has increased. Evaluation of reperfusion has been carried out by Doppler scan; however, a successful PTA does not necessarily result in improved oxygen delivery to the distal parts of the limb.


OBJECTIVE
To evaluate the efficacy of the revascularization in diabetic patients with critical limb ischemia after treatment with PTA by comparing transcutaneous oxygen tension (TcpO₂) with the ankle-brachial index (ABI) post PTA.


METHODS
This prospective study included 151 consecutive diabetic patients. We evaluated the posterior tibial and dorsalis pedis Doppler, ABI, TcpO₂, and duplex scan results. If two of these four examinations were abnormal, arteriography was carried out and PTA was performed concomitantly. At least 64 patients were considered suitable candidates for PTA.


RESULTS
The ABI increased from 0.67±0.25 to 0.84±0.25 following PTA (P<0.001). TcpO₂ increased from 27.20±11.10 mm Hg to 40±12.10 mm Hg after PTA (P<0.001). While the TcpO₂ could be measured in all patients, the ABI was not measurable in 25.37% pretreatment and in 17.91% post treatment. Statistical analysis revealed a scant correlation between the techniques used: TcpO₂ and ABI (P=0.20).


CONCLUSIONS
Our study confirms that the increase in TcpO₂ in diabetic patients following PTA points to the physiologic significance of microvascular revascularization achieved in the treated limb and serves to assess functional improvement in tissue oxygenation obtained by PTA. The use of TcpO₂ may represent an alternative to traditional assessment of peripheral transluminal angioplasty results.
Pardo
Manuel
M
Department of Radiology and Physical Medicine, Faculty of Medicine/Dentistry, University of Murcia, Espinardo, Murcia, Spain.
Alcaraz
Miguel
M
Ramón Breijo
Francisco
F
Bernal
Fernando Luis
FL
Felices
Jose Manuel
JM
Canteras
Manuel
M
D000368:Aged; D000369:Aged, 80 and over; D000792:Angiography; D017130:Angioplasty / Q000379:methods*; D001157:Arterial Occlusive Diseases / Q000097:blood / Q000000981:diagnostic imaging / Q000628:therapy*; D001785:Blood Gas Monitoring, Transcutaneous; D017719:Diabetic Foot / Q000097:blood / Q000000981:diagnostic imaging / Q000628:therapy*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010100:Oxygen / Q000097:blood*; D016491:Peripheral Vascular Diseases / Q000097:blood / Q000000981:diagnostic imaging / Q000628:therapy*; D011312:Pressure; D011446:Prospective Studies; D012044:Regression Analysis; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D014463:Ultrasonography
D010100:Oxygen