Skin perfusion pressure measurement is valuable in the diagnosis of critical limb ischemia

Abstract

We conclude that SPP measurement is an objective, noninvasive method that can be used to diagnose critical limb ischemia with approximately 80% accuracy.

Assessment of the Characteristics and Detectability of Skin Perfusion Pressure Measured Using a Thermostatic Heating Probe

“…1) Castronuovo, et al used a warm heating pad for 15 minutes when baseline skin perfusion was less than 0.3 volume % units before the measurement. 1) In contrast, the thermostatic heating probe can elevate and stabilize skin perfusion in about 1 minute, which is very helpful and advantageous in SPP measurement. Although there are currently no reports regarding SPP measurement using a thermostatic heating probe, we projected that the use of such probe would be convenient to improve SPP measurement in ischemic limbs.…”

“…1) For SPP measurement, the examination room must be warm and the limbs must be properly warmed. However, even in an adequately warmed examination room, it remains troublesome and time-consuming to warm cold limbs, particularly for outpatients.…”

Skin Perfusion Pressure Measurement to Assess Improvement in Peripheral Circulation after Arterial Reconstruction for Critical Limb Ischemia

“…The postoperative SPP values in group N were better than those in group U but less than those in group H. Compared with group H, group N featured more patients with chronic kidney disease and group U had even more. Additionally, groups N and U included more patients with diabetes than group H; therefore, the patients in groups N and U could have had more advanced distal lesions than did the patients in group H. [12][13][14] Previous studies have suggested a value of 30 mmHg 1,2,6) or 40 mmHg 4,5) to be the critical SPP threshold necessary for wound healing. In the present study, 50% of the limbs had a mean postoperative SPP value of <30 mmHg in group U, consistent with the results of previous reports.…”

“…1,2,[4][5][6] We started SPP measurements following the establishment of a vascular laboratory at our institution in August 2008. Although the number of examinations of SPP is still small in our institution at present, we deemed it useful to have an initial evaluation of its effectiveness by retrospectively assessing the changes in SPP values obtained between the pre-and postoperative periods 8,9) and the relationship between the SPP values and ulcer healing, in order to assess the utility of SPP measurement in evaluating the outcome of arterial reconstructions in patients with CLI caused by arteriosclerosis obliterans (ASO).…”

“…[1][2][3][4][5] SPP measurement is a noninvasive method of estimating microcirculation of the limbs at a depth of 1.5 to 2.0 mm beneath the skin using a Doppler laser probe. The ankle-brachial pressure index (ABI) is internationally considered to be the optimum method to estimate peripheral circulation.…”