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CardioVascular and Interventional Radiology
Published in: CardioVascular and Interventional Radiology 2/2011

01-04-2011 | Clinical Investigation

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

Authors: Ulf Redlich, Yan Y. Xiong, Maciej Pech, Jörg Tautenhahn, Zuhir Halloul, Ralf Lobmann, Daniela Adolf, Jens Ricke, Oliver Dudeck

Published in: CardioVascular and Interventional Radiology | Issue 2/2011

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Abstract

Purpose

To assess postprocedural angiograms, the ankle–brachial index (ABI), and transcutaneous oxygen tension (TcPO2) 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 TcPO2 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. TcPO2 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, TcPO2 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. TcPO2 was a valid predictor for limb salvage, even when angiographic outcome criteria failed.
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Metadata
Title
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
Authors
Ulf Redlich
Yan Y. Xiong
Maciej Pech
Jörg Tautenhahn
Zuhir Halloul
Ralf Lobmann
Daniela Adolf
Jens Ricke
Oliver Dudeck
Publication date
01-04-2011
Publisher
Springer-Verlag
Published in
CardioVascular and Interventional Radiology / Issue 2/2011
Print ISSN: 0174-1551
Electronic ISSN: 1432-086X
DOI
https://doi.org/10.1007/s00270-010-9968-x

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