Superiority of Transcutaneous Oxygen Tension Measurements in Predicting Limb Salvage After Below-the-Knee Angioplasty: A Prospective Trial in Diabetic Patients With Critical Limb Ischemia

Journal Article · Fri Apr 15 04:00:00 EDT 2011 · Cardiovascular and Interventional Radiology

DOI:https://doi.org/10.1007/S00270-010-9968-X· OSTI ID:21608711

Redlich, Ulf; Xiong, Yan Y; Pech, Maciej ^[1]; Tautenhahn, Joerg; Halloul, Zuhir ^[2]; Lobmann, Ralf ^[3]; Adolf, Daniela ^[4]; Ricke, Jens; Dudeck, Oliver ^[1]

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1. University of Magdeburg, Department of Radiology and Nuclear Medicine (Germany)
2. University of Magdeburg, Department of Vascular Surgery (Germany)
3. University of Magdeburg, Department of Endocrinology (Germany)
4. University of Magdeburg, Institute of Biometry and Medical Informatics (Germany)

Purpose: To assess postprocedural angiograms, the ankle-brachial index (ABI), and transcutaneous oxygen tension (TcPO{sub 2}) to predict outcome after infrageniculate angioplasty (PTA) in diabetic patients with critical limb ischemia (CLI) scheduled for amputation. Materials and Methods: PTA was performed in 28 diabetic patients with CLI confined to infrapopliteal vessels. We recorded patency of crural vessels, including the vascular supply of the foot as well as the ABI and TcPO{sub 2} of the foot. Results: Technical success rate was 92.9% (n = 26), and limb-salvage rate at 12 months was 60.7% (n = 17). The number of patent straight vessels above and below the level of the malleoli increased significantly in patients avoiding amputation. Amputation was unnecessary in 88.2% (n = 15) patients when patency of at least one tibial artery was achieved. In 72.7% (n = 8) of patients, patency of the peroneal artery alone was not sufficient for limb salvage. ABI was of no predictive value for limb salvage. TcPO{sub 2} values increased significantly only in patients not requiring amputation (P = 0.015). In patients with only one tibial artery supplying the foot or only a patent peroneal artery in postprocedural angiograms, TcPO{sub 2} was capable of reliably predicting the outcome. Conclusion: Below-the-knee PTA as an isolated part of therapy was effective to prevent major amputation in more than a half of diabetic patients with CLI. TcPO{sub 2} was a valid predictor for limb salvage, even when angiographic outcome criteria failed.

• OSTI ID: 21608711
• Journal Information: Cardiovascular and Interventional Radiology, Journal Name: Cardiovascular and Interventional Radiology Journal Issue: 2 Vol. 34; ISSN 0174-1551; ISSN CAIRDG
• Country of Publication: United States
• Language: English

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62 RADIOLOGY AND NUCLEAR MEDICINE
ANEMIAS
ARTERIES
BLOOD VESSELS
BODY
BONE JOINTS
CARDIOVASCULAR DISEASES
CARDIOVASCULAR SYSTEM
CONTAINERS
DISEASES
ELEMENTS
FEET
HEMIC DISEASES
ISCHEMIA
LEGS
LIMBS
MATERIALS
MEDICINE
NONMETALS
ORGANS
OXYGEN
PATIENTS
SKELETON
SYMPTOMS
THERAPY
VASCULAR DISEASES