Superiority of Transcutaneous Oximetry in Noninvasive Vascular Diagnosis in Patients With Diabetes

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Abstract
• Transcutaneous oxygen tension Ptco2 is directly related to skin oxygen delivery. Regional transcutaneous oximetry (RTO) compares peripheral and truncal (PtcO2)3 yielding a regional perfusion index indicative of local limb perfusion. The relative diagnostic values of RTO, Doppler ankle-brachial pressure ratio (ABR), pulse volume recording (PVR), and toe pulse reappearance time (PRT/2) were studied in 64 limbs of patients with diabetes. These limbs were clinically classifiable into claudication, rest pain, and gangrene groups. Regional transcutaneous oximetry had a higher diagnostic accuracy than ABR (χ2 = 27.47, P<.001), PVR (χ2 = 7.54, P <.01), and PRT/2 (χ2=10.99, P<.001). Regional transcutaneous oximetry was universally applicable and the degree of hypoxia observed correlated with clinical symptoms. Significant hypoxia predicted large-vessel angiographic lesions, many of which were reconstructible. Regional transcutaneous oximetry should be the initial noninvasive test in diabetic peripheral vascular disease. (Arch Surg 1984;119:690-694)