Tsai FW, Tulsyan N, Jones DN, Abdel-Al N, Castronuovo JJ Jr, Carter SA, et al.
Journal of vascular surgery. Date of publication 2000 Jul 1;volume 32(1):32-6.
1. J Vasc Surg. 2000 Jul;32(1):32-6.
Skin perfusion pressure of the foot is a good substitute for toe pressure in the
assessment of limb ischemia.
Tsai FW(1), Tulsyan N, Jones DN, Abdel-Al N, Castronuovo JJ Jr, Carter SA.
Author information:
(1)Morristown Memorial Hospital, the University of Colorado Health Services
Center, Denver, CO, USA.
PURPOSE: Noninvasive measurements of limb systolic pressures are used routinely
in the assessment of the severity of peripheral arterial disease, including the
evaluation for critical limb ischemia. However, ankle pressures cannot be
measured reliably in patients with medial calcification, which is especially
common among patients with diabetes. Skin lesions on the toes or previous digital
amputations may preclude the measurement of toe pressures. Measurements of skin
perfusion pressure (SPP) are not subject to such limitations and were shown to be
useful in the assessment of the severity of peripheral arterial disease. Because
toe pressure is often used in the evaluation of severity of arterial disease and
in the assessment for critical ischemia, we undertook to study whether there is a
sufficient correlation between toe pressure and foot SPP that would allow the use
of SPP measurements when toe pressures cannot be measured.
METHODS: Measurements were carried out in 85 limbs of 71 patients referred to the
vascular laboratory for evaluation for peripheral arterial disease. Diabetes
mellitus was present in 43 patients. Each patient had foot SPP and toe pressure
measurements. Toe pressures measured with photoplethysmography were correlated
with foot SPP measured with laser Doppler scanning.
RESULTS: There was a strong linear correlation between SPP and toe pressure (r =
0.87; P <.01). Also, significant correlation was found in both the patients with
diabetes and the patients without diabetes (r = 0.85 and 0.93, respectively; P
<.01 in both cases).
CONCLUSIONS: We concluded that SPP measured in the foot correlates well with toe
pressure and can be substituted for toe pressure measurement in patients in whom
toe pressures cannot be measured.
DOI: 10.1067/mva.2000.107310
PMID: 10876204 [Indexed for MEDLINE]
