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June 1984

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

Author Affiliations

From the Departments of Surgery (Drs Hauser, Klein, Appel, Shoemaker) and Radiology (Dr Mehringer), Harbor/UCLA Medical Center, Torrance, Calif.

Arch Surg. 1984;119(6):690-694. doi:10.1001/archsurg.1984.01390180054009

• 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)