PURPOSE: We evaluated the limitations of the ankle-brachial index (ABI) in the revascularisation of diabetic patients with critical limb ischaemia (CLI) who were undergoing peripheral transluminal angioplasty (PTA) compared with the degree of arterial stenosis and with transcutaneous oxygen tension (TcpO2). MATERIALS AND METHODS: This prospective study assessed 250 consecutive diabetic patients in whom we evaluated results of posterior tibial and dorsalis pedis Doppler, ABI, TcpO2, and duplex scans. In total, 104 patients were considered suitable candidates for PTA. RESULTS: In 42% of the patients studied, ABI could either not be used (9.34% due to no signal; 14.02% because the artery could not be compressed) or was incorrect (18.7% before PTA; 15.9% after PTA). In contrast, TcpO2 was determined in all cases. After PTA, vessel stenosis decreased from 58.33±20.07% to 21.87±13.57% (p<0.001), whereas ABI increased from 0.79±0.57 to 0.95±0.47 (p<0.001) and TcpO2 from 27.37±10.40 mmHg to 38.23±10.25 mmHg (p<0.001). A statistical analysis revealed scant correlation between techniques (TcpO2 and ABI) (r=0.14). CONCLUSIONS: ABI shows significant limitations for the diagnosing and treating CLI patients compared with TcpO2.
PURPOSE: We evaluated the limitations of the ankle-brachial index (ABI) in the revascularisation of diabeticpatients with critical limb ischaemia (CLI) who were undergoing peripheral transluminal angioplasty (PTA) compared with the degree of arterial stenosis and with transcutaneous oxygen tension (TcpO2). MATERIALS AND METHODS: This prospective study assessed 250 consecutive diabeticpatients in whom we evaluated results of posterior tibial and dorsalis pedis Doppler, ABI, TcpO2, and duplex scans. In total, 104 patients were considered suitable candidates for PTA. RESULTS: In 42% of the patients studied, ABI could either not be used (9.34% due to no signal; 14.02% because the artery could not be compressed) or was incorrect (18.7% before PTA; 15.9% after PTA). In contrast, TcpO2 was determined in all cases. After PTA, vessel stenosis decreased from 58.33±20.07% to 21.87±13.57% (p<0.001), whereas ABI increased from 0.79±0.57 to 0.95±0.47 (p<0.001) and TcpO2 from 27.37±10.40 mmHg to 38.23±10.25 mmHg (p<0.001). A statistical analysis revealed scant correlation between techniques (TcpO2 and ABI) (r=0.14). CONCLUSIONS: ABI shows significant limitations for the diagnosing and treating CLI patients compared with TcpO2.
Authors: Manuel Pardo; Miguel Alcaraz; Francisco Ramón Breijo; Fernando Luis Bernal; Jose Manuel Felices; Manuel Canteras Journal: Acta Radiol Date: 2010-11 Impact factor: 1.990
Authors: Richard F Neville; Christopher E Attinger; Erwin J Bulan; Ivica Ducic; Michael Thomassen; Anton N Sidawy Journal: Ann Vasc Surg Date: 2009-01-29 Impact factor: 1.466
Authors: Alan T Hirsch; Ziv J Haskal; Norman R Hertzer; Curtis W Bakal; Mark A Creager; Jonathan L Halperin; Loren F Hiratzka; William R C Murphy; Jeffrey W Olin; Jules B Puschett; Kenneth A Rosenfield; David Sacks; James C Stanley; Lloyd M Taylor; Christopher J White; John White; Rodney A White; Elliott M Antman; Sidney C Smith; Cynthia D Adams; Jeffrey L Anderson; David P Faxon; Valentin Fuster; Raymond J Gibbons; Jonathan L Halperin; Loren F Hiratzka; Sharon A Hunt; Alice K Jacobs; Rick Nishimura; Joseph P Ornato; Richard L Page; Barbara Riegel Journal: J Am Coll Cardiol Date: 2006-03-21 Impact factor: 24.094