Influence of percutaneous transluminal angioplasty on transcutaneous oxygen pressure in patients with peripheral arterial occlusive disease.

摘要

PURPOSE: To determine in a prospective controlled trial the effect of percutaneous transluminal angioplasty (PTA) on skin oxygen supply and microcirculation as measured by means of transcutaneous oxygen pressure in patients with disabling lower-limb ischemia compared with that in patients who underwent intraarterial angiography for the assessment of disabling lower-limb ischemia. MATERIALS AND METHODS: Thirty-four patients (17 men, 17 women; mean age, 68.6 years +/- 9.8 [SD]) with peripheral arterial occlusive disease (PAOD) (claudication, n = 15; critical ischemia, n = 19) underwent transcutaneous oxygen pressure measurement at the dorsum of the foot 1 day before PTA, during PTA, 1 day after PTA, and 6 weeks after PTA. Measurements were obtained with the patient in the supine and erect sitting positions, as well as after exercise. Thirty-one patients (21 men, 10 women; mean age, 68.5 years +/- 9.3) with symptomatic PAOD who were undergoing intraarterial angiography served as the control group. RESULTS: Mean pressure before PTA was 31.6 mm Hg +/- 24 in the supine position, 50.8 mm Hg +/- 22 in the sitting position, and 22.2 mm Hg +/- 23 after exercise. Immediately after PTA, a significant increase to 34 mm Hg +/- 20 in the supine position was noted (P <.05). One day after PTA, pressure was 37.3 mm Hg +/- 20 for the supine position and 52 mm Hg +/- 20 for the sitting position. Six weeks after treatment, a further significant increase to 43.9 mm Hg +/- 19 in the supine position, 61 mm Hg +/- 15 in the sitting position, and 44.7 mm Hg +/- 24 after exercise was noted (P <.05). In the control group, a significant pressure decrease immediately after and 1 day after angiography was noted (P <.05). Measurements returned to baseline at 6 weeks follow-up. CONCLUSION: PTA has a positive effect on oxygen supply to the skin in patients with PAOD. Conversely, intraarterial angiography in patients with PAOD deteriorates skin microcirculation temporarily. Copyright RSNA, 2003