Document Detail

Haemodynamics of patients with severe lower limb arterial disease: the critical aspects of critical ischaemia.
MedLine Citation:
PMID:  9366792     Owner:  NLM     Status:  MEDLINE    
OBJECTIVES: To compare the value of ankle and toe pressures as regards the diagnosis of critical ischaemia, its prognosis, and the need for vascular surgery. DESIGN: University hospital-based retrospective study. MATERIALS AND METHODS: Fifty-seven patients (23 women and 34 men) with gangrene or rest pain had a haemodynamic evaluation combining ankle systolic pressure, toe pressure and cutaneous oximetry (tcPO2) with long-term follow-up (until death, for 44%). RESULTS: After 2 years of follow-up, actuarial rates were 49 and 79% for survival and limb salvage, respectively. Ankle and toe pressures gave rise to different subsets of patients, p < 0.001, mainly because of the existence of a group of patients with very distal foot arterial disease. Low ankle pressure was linked to the risk of major amputation. Low toe pressure was linked to a great need for vascular surgery. Diabetes increased the risk of minor amputation. CONCLUSIONS: The concept of critical ischaemia remains clinically relevant. Haemodynamic quantitative data strengthen this concept, but ankle and toe pressures are not interchangeable parameters. For these reasons, toe pressures should be changed from a recommended to a mandatory haemodynamic parameter in the definition of critical ischaemia.
M Vayssariat; P Gouny; C Cheynel; J P Gaitz; N Baudot; O Nussaume
Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  European journal of vascular and endovascular surgery : the official journal of the European Society for Vascular Surgery     Volume:  14     ISSN:  1078-5884     ISO Abbreviation:  Eur J Vasc Endovasc Surg     Publication Date:  1997 Oct 
Date Detail:
Created Date:  1997-12-04     Completed Date:  1997-12-04     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  9512728     Medline TA:  Eur J Vasc Endovasc Surg     Country:  ENGLAND    
Other Details:
Languages:  eng     Pagination:  284-9     Citation Subset:  IM    
Laboratory of Microcirculation, Tenon Hospital, University of Paris VI, France.
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MeSH Terms
Aged, 80 and over
Arterial Occlusive Diseases / mortality,  physiopathology*
Critical Illness
Gangrene / mortality,  physiopathology
Leg / blood supply*
Middle Aged
Retrospective Studies
Risk Factors
Survival Rate

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