Izzo Valentina, Meloni Marco, Fabiano Sebastiano, Morosetti Daniele, Giurato Laura, Chiaravalloti Antonio, Ruotolo Valeria, Gandini Roberto, Uccioli Luigi
Department of Systems Medicine, University of Tor Vergata, Viale Oxford 81, 00133, Rome, Italy.
Department of Diagnostic Imaging and Interventional Radiology, University of Tor Vergata, Viale Oxford 81, 00133, Rome, Italy.
Cardiovasc Intervent Radiol. 2017 Jan;40(1):120-124. doi: 10.1007/s00270-016-1434-y. Epub 2016 Aug 3.
To demonstrate the usefulness of rearfoot transcutaneous oximetry to assess the peripheral arterial disease in diabetic patients with heel ulcer.
From our database of 550 critical limb ischemia diabetic patients followed after a percutaneous transluminal angioplasty, we have selected patients with below the knee arterial disease. Patients were grouped according to the dorsal transcutaneous oximetry value (Group A < 30 mmHg; Group B ≥ 30 mmHg). Patients of Group B had a second oximetry performed at the rearfoot, close to the lesion localized in all cases at the heel. Finally, the analysis of the arterial pattern disease has been done.
We selected 191 patients: Group A (151 patients), dorsal transcutaneous oximetry of 11.8 ± 0.7 mmHg; Group B (40 patients), dorsal transcutaneous oximetry of 44.2 ± 10.1 mmHg. In Group B, rearfoot oximetry was 20.5 ± 5 mmHg, significantly lower than dorsal oximetry (p = 0.0179). The anterior tibial artery was involved in all patients of Group A. In Group B, the anterior tibial artery was involved in 15 subjects and never alone; the posterior tibial artery was involved in 20 subjects and in 11 cases alone. The peroneal artery was affected in 20 subjects and in 14 patients alone.
When a heel lesion is present and the transcutaneous oximetry recorded on the dorsum of the foot does not confirm the presence of critical limb ischemia (not ≤30 mmHg), a second oximetry recorded on the rearfoot is useful to point out ischemia of the peroneal artery and/or of the posterior tibial artery.
证明后足经皮血氧测定法在评估患有足跟溃疡的糖尿病患者外周动脉疾病方面的实用性。
从我们对550例接受经皮腔内血管成形术后随访的严重肢体缺血糖尿病患者的数据库中，选取患有膝下动脉疾病的患者。根据经皮血氧测定值对患者进行分组（A组<30 mmHg；B组≥30 mmHg）。B组患者在靠近病变部位（所有病例均位于足跟）的后足进行第二次血氧测定。最后，对动脉疾病模式进行了分析。
我们选取了191例患者：A组（151例患者），经皮血氧测定值为11.8±0.7 mmHg；B组（40例患者），经皮血氧测定值为44.2±10.1 mmHg。在B组中，后足血氧测定值为20.5±5 mmHg，显著低于经皮血氧测定值（p = 0.0179）。A组所有患者的胫前动脉均受累。在B组中，15例患者的胫前动脉受累且并非单独受累；20例患者的胫后动脉受累，其中11例单独受累。20例患者的腓动脉受累，其中14例单独受累。
当存在足跟病变且足部背侧记录的经皮血氧测定不能证实存在严重肢体缺血（不≤30 mmHg）时，在后足记录的第二次血氧测定有助于指出腓动脉和/或胫后动脉的缺血情况。
