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Transcutaneous Oxygen Tension (TcPO2) Measurement as a Diagnostic Tool in Patients with Peripheral Vascular Disease

From the Istituto di Medicina Clinica, Clinica Medica I, Università di Padova, Padova, Italy

Adriana Visona

From the Istituto di Medicina Clinica, Clinica Medica I, Università di Padova, Padova, Italy

Patrizia Nicolin

From the Istituto di Medicina Clinica, Clinica Medica I, Università di Padova, Padova, Italy

Barbara Papesso

Antonio Pagnan

From the Cattedra di Patologia Medica, C.L.O., Università di Padova, Padova, Italy

Transcutaneous oxygen tension (TcPO₂) was measured through Clark's elec trode at the dorsum of the foot in 52 healthy controls whose ages ranged from twenty to sixty-five years (mean 45.05 ±14.09) and 36 nondiabetic patients with peripheral vascular disease (PVD) (5 stage I, 16 stage II, 4 stage III, 11 stage IV), under standardized conditions at rest and during recovery from limb ische mia obtained with pneumatic cuff compression for 3 minutes.

At rest the TcPO₂ averaged 71.20±14.26 mm Hg (range 46-92) in the con trols and 51.56±26.38 in the PVD patients (p < .01). A wide overlap was ob served between the two groups and among the different stages of the disease, and consequently, the diagnostic value of TcPO₂ at rest was limited (sensitivity equal to 32%). During the recovery from ischemia the time constant (recovery half-time, T) averaged 38.01±7.23 sec in the controls and 55.84 ± 19.82 in the PVD patients (p < .01). The T added to the diagnostic value of the method, making it more sensitive (55%), especially for stage II patients. The TcPO₂ at rest was lower with increasing severity of the disease; both the TcPO₂ at rest and the T correlated with the ankle-arm pressure index in the diseased limbs (r = .48 and - .41 respectively, p < .001).

The method showed a limited degree of reproducibility in the controls when the right and the left lower extremity were compared in each subject; in fact, the intrasubject variance of TcPO₂ and T was of the same magnitude as the intersubject variance (F=1.73 and 1.26 respectively), and the standard devia tions of the difference between lower extremities was elevated (13.32 mm Hg for TcPO₂ and 7.80 sec for T). Moreover, the T decreased with increasing age in the controls (r = - .47, p < .001).

The authors conclude that, although it is a good indicator of the severity of PVD, the TcPO₂ has a limited diagnostic value in this kind of patients, owing to the wide range of normalcy, to the low degree of reproducibility in a single individual, and to the influence of the age factor.

Angiology, Vol. 39, No. 10, 873-880 (1988)
DOI: 10.1177/000331978803901004


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