Increased transcutaneous oxygen pressure is an indicator of revascularization after peripheral transluminal angioplasty

Abstract

Background: In recent years, the use of peripheral transluminal angioplasty (PTA) procedures for revascularization of an ischemic limb has increased. Evaluation of reperfusion has been carried out by Doppler scan; however, a successful PTA does not necessarily result in improved oxygen delivery to the distal parts of the limb. Purpose: To evaluate the efficacy of the revascularization in diabetic patients with critical limb ischemia after treatment with PTA by comparing transcutaneous oxygen tension (TcpO2) with the ankle-brachial index (ABI) post PTA. Material and Methods: This prospective study included 151 consecutive diabetic patients. We evaluated the posterior tibial and dorsalis pedis Doppler, ABI, TcpO2, and duplex scan results. If two of these four examinations were abnormal, arteriography was carried out and PTA was performed concomitantly. At least 64 patients were considered suitable candidates for PTA. Results: The ABI increased from 0.67±0.25 to 0.84±0.25 following PTA ( P<0.001). TcpO2 increased from 27.20±11.10 mm Hg to 40±12.10 mm Hg after PTA ( P<0.001). While the TcpO2 could be measured in all patients, the ABI was not measurable in 25.37% pretreatment and in 17.91% post treatment. Statistical analysis revealed a scant correlation between the techniques used: TcpO2 and ABI ( P=0.20). Conclusion: Our study confirms that the increase in TcpO2 in diabetic patients following PTA points to the physiologic significance of microvascular revascularization achieved in the treated limb and serves to assess functional improvement in tissue oxygenation obtained by PTA. The use of TcpO2 may represent an alternative to traditional assessment of peripheral transluminal angioplasty results.