Transcutaneous oxygen tension measurements following peripheral transluminal angioplasty procedure has more specificity and sensitivity than ankle brachial index

Pardo, Manuel; Baños, Miguel Alcaraz; Bernal, Fernando; Felices, Jose Manuel; Achel, G.D.; Canteras, Manuel

doi:10.1259/bjr.20140571

Cited by 17 publications

(11 citation statements)

References 17 publications

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“…23 The increase in the TcPO 2 following PTA has a higher specificity and sensitivity than ABI. 20,24 In this study, the TcPO 2 standards for grouping the severity of ischaemia were selected on the basis of the minimal TcPO 2 thought to be required for adequate wound healing; conversely, the opinions of researchers and clinicians vary, with almost all estimates falling between values of 20 and 40 mm Hg. 22,[25][26][27][28] Toe pressure measurement is also the recommended method for assessing the severity of ischaemia.…”

Section: Discussionmentioning

confidence: 99%

Comparison of perfusion values after percutaneous transluminal angioplasty according to the severity of ischaemia in the diabetic foot

Namgoong

Yang

Yoo

et al. 2018

International Wound Journal

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Percutaneous transluminal angioplasty (PTA) is now more frequently used to improve tissue perfusion in ischemic diabetic feet. However, there are concerns about its feasibility and effectiveness in severely ischaemic feet. This study aimed to compare the perfusion values after PTA according to the ischaemic degree of diabetic feet. This study included 133 ischaemic diabetic feet. The foot transcutaneous oxygen pressure (TcPO2) and toe pressure were measured before the procedure and every second postoperative week for 6 weeks. The patients were divided into three groups according to ischaemic severity on the basis of TcPO2 and toe pressures. In the “severely ischaemic” group, the TcPO2 increased from 7.5 ± 4.9 to 40.3 ± 11.3 mm Hg (5.4‐fold) 6 weeks after the PTA (P < 0.001). The toe pressure increased from 8.5 ± 8.8 to 42.2 ± 19.3 mm Hg (5.0‐fold, P < 0.001). In the “mild” group, the TcPO2 increased from 35.4 ± 2.5 to 41.8 ± 12.4 mm Hg (1.2‐fold, P = 0.003), and the toe pressure increased from 45.7 ± 12.3 to 54.3 ± 31.3 mm Hg (1.2‐fold, P > 0.05). Results of the “intermediate” group were in between. The most severely ischaemic group had the most dramatic increase of tissue perfusion after PTA. As such, PTA can be an effective method for increasing tissue perfusion even in the severely ischaemic diabetic feet.

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Section: Discussionmentioning

confidence: 99%

Comparison of perfusion values after percutaneous transluminal angioplasty according to the severity of ischaemia in the diabetic foot

Namgoong

Yang

Yoo

et al. 2018

International Wound Journal

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“…As a consequence, there are limited comparative data among devices. 86 The premarket approval pathway should in part depend on the mechanism of action of the device: blood flow mediated, measuring tissue oxygen, perfusion, or molecular imaging. In certain circumstances, a comparative study would be helpful to identify gaps where certain devices would be superior to others.…”

Section: Evaluation Of Therapiesmentioning

confidence: 99%

“…There were no randomized controlled trials and several small cohort studies supporting the use of noninvasive perfusion techniques such as ABI, toe pressure, TBI, duplex ultrasound, SPP, and TcPo 2 in identification of CLI postprocedure revascularization failure or impaired wound healing. 22,86,105 An increase in ABI, toe pressure, TBI, or TcPo 2 post procedure supported revascularization and wound healing. 22,86,105 An SPP >30 mm Hg also predicted wound healing.…”

Section: Opportunities To Identify Procedural Failures or Incomplete mentioning

confidence: 99%

“…22,86,105 An increase in ABI, toe pressure, TBI, or TcPo 2 post procedure supported revascularization and wound healing. 22,86,105 An SPP >30 mm Hg also predicted wound healing. 106 Concerns with these studies include small sample size, type of study (observational), and lack of standardized or incomplete follow-up.…”

Section: Opportunities To Identify Procedural Failures or Incomplete mentioning

confidence: 99%

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Perfusion Assessment in Critical Limb Ischemia: Principles for Understanding and the Development of Evidence and Evaluation of Devices: A Scientific Statement From the American Heart Association

Misra¹,

Shishehbor²,

Takahashi³

et al. 2019

Circulation

101

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There are >12 million patients with peripheral artery disease in the United States. The most severe form of peripheral artery disease is critical limb ischemia (CLI). The diagnosis and management of CLI is often challenging. Ethnic differences in comorbidities and presentation of CLI exist. Compared with white patients, black and Hispanic patients have higher prevalence rates of diabetes mellitus and chronic renal disease and are more likely to present with gangrene, whereas white patients are more likely to present with ulcers and rest pain. A thorough evaluation of limb perfusion is important in the diagnosis of CLI because it can not only enable timely diagnosis but also reduce unnecessary invasive procedures in patients with adequate blood flow or among those with other causes for ulcers, including venous, neuropathic, or pressure changes. This scientific statement discusses the current tests and technologies for noninvasive assessment of limb perfusion, including the ankle-brachial index, toe-brachial index, and other perfusion technologies. In addition, limitations of the current technologies along with opportunities for improvement, research, and reducing disparities in health care for patients with CLI are discussed.

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“…In recent years, transcutaneous oxygen pressure (TcPO 2 ) has proven a solution and alternative to assessing PTA results. [ 4 – 6 ]…”

Section: Introductionmentioning

confidence: 99%

Improvement of quality of life in diabetic patients treated with percutaneous transluminal angioplasty

Páez¹,

Baños²,

Abad³

et al. 2018

Medicine

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To assess the quality of life (QoL) of treated patients in order to evaluate the success of peripheral transluminal angioplasty (PTA) and correlate physical parameters with clinical progress at 6 months post-PTA.According to TASC II classifications, 69 patients were selected for PTA. Clinical evaluation and diagnostic tests were performed before, after and after 6 months following PTA. The SF-36 QoL questionnaire was added as an additional parameter.Fifty one patients were included in the study. The ankle-brachial index (ABI) increased from 0.49 ± 0.11 before PTA, to 0.81 ± 0.14 after PTA (P < .001) and 0.76 ± 0.10 at 6 months following PTA (P < .001). Transcutaneous oxygen pressure (TcPO2) increased from 28.05 ± 3.15 mm Hg before PTA, to 39.89 ± 4.12 after PTA (P < .001) and 46.4 ± 3.81 at 6 months following PTA (P < .001). The lumen of the affected blood vessel increased from 29 ± 18% before PTA, to 81 ± 10.3% after PTA (P < .001). SF-36 values increased from 29 ± 18 before PTA, to 81 ± 10.36 at 6 months following PTA (P < .001).The improvement of QoL is the parameter that best describes the symptoms and functionality of the patient, therefore, should be used to determine the successful PTA. Although ABI and TcPO2 with arteries functionality and tissue oxygenation, they are not show a significant correlation with all parameters determined in the QoL questionnaire.

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Transcutaneous oxygen tension measurements following peripheral transluminal angioplasty procedure has more specificity and sensitivity than ankle brachial index

Abstract: This is the first time that a graph is shown with TcPO2 results during PTA performance in many patients.

Cited by 17 publications

References 17 publications

Comparison of perfusion values after percutaneous transluminal angioplasty according to the severity of ischaemia in the diabetic foot

Comparison of perfusion values after percutaneous transluminal angioplasty according to the severity of ischaemia in the diabetic foot

Perfusion Assessment in Critical Limb Ischemia: Principles for Understanding and the Development of Evidence and Evaluation of Devices: A Scientific Statement From the American Heart Association

Improvement of quality of life in diabetic patients treated with percutaneous transluminal angioplasty

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