Intraoperative Evaluation of Success and Failure of Vascular Reconstruction by Monitoring the Transcutaneous Partial Pressure of Oxygen

Abstract

This investigation was to determine whether intraoperative monitoring of the transcutaneous partial pressure of oxygen (tcPo2) can be used to assess the success or failure of vascular reconstruction. A total of 347 limbs in 224 patients were studied, including 136 limbs without ischemic symptoms or signs, 173 limbs with intermittent claudication, and 38 limbs with ischemic rest pain, ulceration, or gangrene. The tcPo2 values were determined just before surgery, just before vascular declamping, at 5-minute intervals for 30 minutes after declamping, and just after surgery. A stable tcPo2 value of ≥ 45 mm Hg within 30 minutes after declamping indicated a good outcome, while graft failure or poor distal vascular runoff was suggested by a tcPo2 level of ≤ 45 mm Hg. Extremely poor results were indicated by persistent tcPo2 levels of < 10 mm Hg. Continuous tcPo2 measurement can be used to sensitively reflect distal tissue perfusion and determine the success or failure of vascular reconstruction.