Blood Pressure in the Great Toe with Simulated occusion of the Dorsalis Peds Artery

Abstract

Blood pressure was measured in both great toes using strain-gauge plethysmography in 100 healthy persons aged 18 to 43 before and during successive compression of the dorsalis pedis artery, the posterior tibial artery, and both arteries at the same time. In 54 (27 percent) of 200 feet, successive compression of the dorsalis pedis and the posterior tibial arteries produced no decrease in pressure in the great toe. In 47 of the feet, toe pressure decreased significantly only after compression of the posterior tibial artery, and in 65 of the feet toe pressure decreased significantly only after compression of the dorsalis pedis artery. In 34 of the feet, toe pressure decreased significantly after compression of each of the arteries. Thus in 99 (50 percent) of 200 feet, compression of the dorsalis pedis artery decreased the pressure in the great toe significantly, and in 4 feet the pressure decreased below 40 mm Hg. When both arteries were simultaneously compressed, 69 feet showed detectable blood pressure in the great toe. Attempts to evaluate adequacy of collateral circulation by pressure blanching of the great toe prior to artery compression and then observing capillary refilling time upon release of toe compression proved unreliable.

Toe Blood Pressure and Leg Muscle Oxygenation with Body Posture

“…Even though it is not commonly used at toe level, in this paper we have validated this fi nger device for measuring beat-by-beat blood pressure noninvasively and accurately in the toe. In comparison to established invasive techniques for toe blood pressure, such as cannulation of the dorsalis pedis artery ( 17 ), this device provides a noninvasive technique to measure systolic and diastolic blood pressures at the toe. This technique could potentially be used in patients with severe burns in the upper extremities or in amputees in which arm blood pressure cannot be measured noninvasively.…”

“…A Velcro strap that holds the Finometer's air pump was loosely wrapped around the lateral aspect of the foot so as to not obstruct the dorsalis pedis artery, the main blood supply to the foot ( 17,18 ). The fi nger cuff of the Finometer was attached to the second toe of the right foot.…”