Predictive value of ultrasonically derived arterial pressure in determination of amputation level.

There is a real need for a reliable guide to determine the lowest level of successful limb amputation. Factors such as wound edge bleeding and clinical judgment cannot be minimized but, when clinical experience had been the sole index, AK amputation has too often resulted. The availability of a pocket-sized Doppler ultrasound pulse detector has made thigh or ankle systolic pressure recording a simple bedside procedure. Our analysis shows that a thigh pressure of 50 mm Hg correlates well with success of BK amputation. This fact can be added to the clinician's judgment in better rehabilitating the elderly ischemic amputee.