title: Rearfoot Transcutaneous Oximetry is a Useful Tool to Highlight Ischemia of the Heel.
abstract: OBJECTIVE
  To demonstrate the usefulness of rearfoot transcutaneous oximetry to assess the peripheral arterial disease in diabetic patients with heel ulcer.
  
  
  METHODS
  From our database of 550 critical limb ischemia diabetic patients followed after a percutaneous transluminal angioplasty, we have selected patients with below the knee arterial disease. Patients were grouped according to the dorsal transcutaneous oximetry value (Group A < 30 mmHg; Group B ≥ 30 mmHg). Patients of Group B had a second oximetry performed at the rearfoot, close to the lesion localized in all cases at the heel. Finally, the analysis of the arterial pattern disease has been done.
  
  
  RESULTS
  We selected 191 patients: Group A (151 patients), dorsal transcutaneous oximetry of 11.8 ± 0.7 mmHg; Group B (40 patients), dorsal transcutaneous oximetry of 44.2 ± 10.1 mmHg. In Group B, rearfoot oximetry was 20.5 ± 5 mmHg, significantly lower than dorsal oximetry (p = 0.0179). The anterior tibial artery was involved in all patients of Group A. In Group B, the anterior tibial artery was involved in 15 subjects and never alone; the posterior tibial artery was involved in 20 subjects and in 11 cases alone. The peroneal artery was affected in 20 subjects and in 14 patients alone.
  
  
  CONCLUSIONS
  When a heel lesion is present and the transcutaneous oximetry recorded on the dorsum of the foot does not confirm the presence of critical limb ischemia (not ≤30 mmHg), a second oximetry recorded on the rearfoot is useful to point out ischemia of the peroneal artery and/or of the posterior tibial artery.
authors.affiliation: Department of Systems Medicine, University of Tor Vergata, Viale Oxford 81, 00133, Rome, Italy. valentina_izzo@virgilio.it.
authors.forename: Valentina
authors.initials: V
authors.lastname: Izzo
authors.affiliation: Department of Systems Medicine, University of Tor Vergata, Viale Oxford 81, 00133, Rome, Italy.
authors.forename: Marco
authors.initials: M
authors.lastname: Meloni
authors.affiliation: Department of Diagnostic Imaging and Interventional Radiology, University of Tor Vergata, Viale Oxford 81, 00133, Rome, Italy.
authors.forename: Sebastiano
authors.initials: S
authors.lastname: Fabiano
authors.affiliation: Department of Diagnostic Imaging and Interventional Radiology, University of Tor Vergata, Viale Oxford 81, 00133, Rome, Italy.
authors.forename: Daniele
authors.initials: D
authors.lastname: Morosetti
authors.affiliation: Department of Systems Medicine, University of Tor Vergata, Viale Oxford 81, 00133, Rome, Italy.
authors.forename: Laura
authors.initials: L
authors.lastname: Giurato
authors.affiliation: Department of Diagnostic Imaging and Interventional Radiology, University of Tor Vergata, Viale Oxford 81, 00133, Rome, Italy.
authors.forename: Antonio
authors.initials: A
authors.lastname: Chiaravalloti
authors.affiliation: Department of Systems Medicine, University of Tor Vergata, Viale Oxford 81, 00133, Rome, Italy.
authors.forename: Valeria
authors.initials: V
authors.lastname: Ruotolo
authors.affiliation: Department of Diagnostic Imaging and Interventional Radiology, University of Tor Vergata, Viale Oxford 81, 00133, Rome, Italy.
authors.forename: Roberto
authors.initials: R
authors.lastname: Gandini
authors.affiliation: Department of Systems Medicine, University of Tor Vergata, Viale Oxford 81, 00133, Rome, Italy.
authors.forename: Luigi
authors.initials: L
authors.lastname: Uccioli
mesh_terms: D000368:Aged; D015331:Cohort Studies; D048909:Diabetes Complications / Q000175:diagnosis* / Q000503:physiopathology; D005260:Female; D006365:Heel / Q000098:blood supply* / Q000503:physiopathology; D006801:Humans; D007511:Ischemia / Q000150:complications / Q000175:diagnosis* / Q000503:physiopathology; D008297:Male; D010092:Oximetry / Q000379:methods*; D058729:Peripheral Arterial Disease / Q000150:complications / Q000175:diagnosis* / Q000503:physiopathology; D012189:Retrospective Studies; D014456:Ulcer / Q000150:complications / Q000503:physiopathology
keywords: Diabetic foot; Heel; Ischemia; Transcutaneous oximetry