Circulation, Vol 72, 1022-1027, Copyright © 1985 by American Heart Association
HB Kram, RA White, J Tabrisky, PL Appel, AW Fleming and WC Shoemaker
The accuracy of measurements of transcutaneous oxygen tension (Ptco2) in
the diagnosis of peripheral vascular disease (PVD) may be significantly
increased by stressing limb circulation with the use of temporary ischemia.
The purpose of this study was to compare the transcutaneous oxygen recovery
half-time (TORT) and the toe pulse reappearance time (PRT/2) in a series of
patients with symptomatic PVD before and after vascular reconstruction. The
TORT was defined as the time required to recover half of the decrease in
the limb/chest Ptco2 ratio caused by temporary limb ischemia, and is
conceptually comparable to the toe PRT/2, the time required to recover half
of the control toe pulse amplitude. Measurement of TORT was found to be
more feasible (100% vs 58%) and to have a greater diagnostic yield (100% vs
92%) than that of the toe PRT/2. When measured on the dorsum of the foot,
TORT values were found to correlate well with the severity of symptoms of
PVD; toe PRT/2 values did not correlate with severity of symptoms. Patients
who underwent successful vascular reconstruction had significant
improvement in their calf and foot TORT values after surgery (p less than
.005 and .0005, respectively); postoperative values were similar to those
obtained in normal subjects. Toe PRT/2 values usually improved
postoperatively, but in many patients postoperative values overlapped with
values that were considered abnormal. There was no overlap of TORT values
in normal subjects with those in patients with symptomatic PVD. The
measurement of TORT may be clinically useful for screening patients with
suspected PVD and for assessing quantitatively the results of conservative
and surgical therapy.(ABSTRACT TRUNCATED AT 250 WORDS)
ARTICLES
Transcutaneous oxygen recovery and toe pulse reappearance time in the assessment of peripheral vascular disease
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