Infrapopliteal Transcatheter Interventions for Limb Salvage in Diabetic Patients: Importance of Aggressive Interventional Approach and Role of Transcutaneous Oximetry

Abstract

Infrapopliteal transcatheter interventions in diabetic patients may salvage the majority of limbs doomed to amputation. Although TCO2 measurements are valuable in predicting wound healing and success after interventions, ABI measurements are not.

Effects of percutaneous transluminal angioplasty on muscle BOLD-MRI in patients with peripheral arterial occlusive disease: preliminary results

“…This effect was recently demonstrated by transcutaneous oxygen pressure measurements (TcPo 2 ), where an improvement of tissue oxygenation is associated with an increase of oxyhemoglobin concentration in the capillary bed [21,22]. It shifts the Hb ox/deox ratio toward higher concentration.…”

Contemporary Infrapopliteal Intervention for Limb Salvage and Wound Healing

“…5,29-31 Microcirculation assessment with skin perfusion pressure (SPP) or transcutaneous oxygen pressure (TCPO2) is strongly recommended, especially for CLI patients undergoing infrapopliteal interventions. 32, 33 In particular, SPP has been gaining popularity because of its simplicity, reproducibility, and reliability. According to Castronuovo et al, 31 SPP values of 40 mmHg or higher are associated with a high likelihood of wound healing in critically ischemic limbs (Figure 2A).…”

Comparison of Clinical Outcome of Infrapopliteal Angioplasty Between Korean Diabetic and Non-Diabetic Patients With Critical Limb Ischemia

“…4,5 PVD in diabetic patients constitutes a major clinical problem and is associated with higher morbidity and mortality. 6 Diabetic patients are 5-fold more likely to develop CLI than non-diabetic patients. 7 One serious complication of PVD is gangrene, which accounts for up to 50% of lower limb amputations in diabetic patients in the Western world.…”