Salaun P, Desormais I, Lapébie FX, Rivière AB, Aboyans V, Lacroix P, Bataille V, Constans J, Boulon C, et al.
Angiology. Date of publication 2019 Mar 1;volume 70(3):229-236.
1. Angiology. 2019 Mar;70(3):229-236. doi: 10.1177/0003319718793566. Epub 2018 Aug
16.
Comparison of Ankle Pressure, Systolic Toe Pressure, and Transcutaneous Oxygen
Pressure to Predict Major Amputation After 1 Year in the COPART Cohort.
Salaun P(1), Desormais I(2), Lapébie FX(3), Rivière AB(3), Aboyans V(4), Lacroix
P(2), Bataille V(5)(6), Constans J(1), Boulon C(1).
Author information:
(1)Médecine vasculaire, Hôpital St Andre, Bordeaux, France.
(2)Médecine vasculaire, Hôpital Dupuytren, Limoges, France.
(3)Service de Médecine Vasculaire, CHU Toulouse, TSA, Toulouse, France.
(4)Service de Cardiologie, Hôpital Universitaire Dupuytren, CHU de Limoges,
Imoges, France.
(5)Stroma Lab UMR 5273/INSERM U1031, Toulouse, France.
(6)Université de Toulouse III, Toulouse, France.
The hemodynamic definition of critical limb ischemia (CLI) has evolved over time
but remains controversial. We compared the prediction of major amputation by 3
hemodynamic methods. Patients were selected from the Cohorte des Patients
ARTériopathes cohort of patients hospitalized for peripheral arterial disease.
Patients with CLI were enrolled according to the Trans-Atlantic Inter-Society
Consensus Document on Management of Peripheral Arterial Disease II definition and
followed up for at least 1 year. We compared the major amputation rate according
to initial ankle pressure (AP), systolic toe pressure (STP), and forefoot
transcutaneous oxygen pressure (TcPO2); 556 patients were included and divided
into surgical (264) and medical (292) groups. The AP failed to identify 42% of
patients with CLI. After 1 year, 27% of medical and 17% of surgical patients had
undergone major amputation. The TP <30 mm Hg predicted major amputation in the
whole sample and in the medical group (odds ratio [OR] 3.5 [1.7-7.1] and OR 5
[2-12.4], respectively), but AP did not. The TcPO2 <10 mm Hg also predicted major
amputation (OR 2.3 [1.5-3.5] and OR 3.8 [2.1-6.8]). The best predictive
thresholds to predict major amputation were STP <30 mm Hg and TcPO2 <10 mm Hg.
None of these methods performed before surgery was able to predict outcome in the
revascularized patients.
DOI: 10.1177/0003319718793566
PMID: 30114947 [Indexed for MEDLINE]
