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Comparative Diagnostic Value of Ankle-to-Brachial Index and Transcutaneous Oxygen Tension at Rest and After Exercise in Patients with Intermittent Claudication

Department of Cardiology C, University of Lille

Alain Millaire

Department of Cardiology C, University of Lille

Guislaine Deklunder

Cardiac Noninvasive Ultrasound Laboratory, University of Lille

Philippe Marache

Department of Radiology, Cardiology Hospital, University of Lille, France

Eric Decoulx

Department of Cardiology C, University of Lille

Gerard Ducloux

Department of Cardiology C, University of Lille

Background: Few studies have compared sensitivities of ankle-to-brachial index (ABI) and transcutaneous oxygen tension (TcPO₂) in a large group of patients with Leriche stage II intermittent claudication.

Method and Results: 111 patients (138 limbs) with a stable chronic (> three months) intermittent claudication and significant peripheral vascular disease (PVD) proved by angiography were studied. They performed a treadmill test (10%, 3 km/hr) limited by limb pain. ABI and TcPO₂ were measured before, just after exercise, and after three and ten minutes of recovery in supine position.

Sensitivities per patient for ABI and TcPO₂ were respectively at rest: 82.9% and 28.8%, and after exercise: 88.3% and 62.2%. Sensitivities per leg (n=138) for ABI and TcPO₂ were respectively at rest: 73.9% and 26.8%, and after exercise: 82.6% and 34%. The sensitivity of TcPO₂ increased to 56.5% after three minutes of recovery but was always less than that of ABI, which was maximal just after exercise (82.6%). The sensi tivity of the regional perfusion index was similar to that of TcPO₂. The sensitivity of TcPO₂ increased with respect to the Leriche stage and the number of lesions but was always lower than that of ABI. There was a weak correlation between TcPO₂ and ABI after exercise, but no correlation was noted between maximal walking distance, ABI, and TcPO₂.

Conclusion: TcPO ₂ is not required in patients with Leriche stage II intermittent clau dication but might be useful either in severely affected patients (Leriche stage III or IV) or in selected patients.

Angiology, Vol. 46, No. 2, 115-122 (1995)
DOI: 10.1177/000331979504600204


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