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Published online before print January 15, 2003, 10.1148/radiol.2263011728
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(Radiology 2003;226:791-797.)
© RSNA, 2003

Vascular and Interventional Radiology

Influence of Percutaneous Transluminal Angioplasty on Transcutaneous Oxygen Pressure in Patients with Peripheral Arterial Occlusive Disease1

Hans-Joachim Wagner, MD, Roland Schmitz, MD, Heiko Alfke, MD and Klaus-Jochen Klose, MD

1 From the Department of Diagnostic Radiology, Philipps University Hospital, Baldingerstrasse, Marburg 35033, Germany (H.J.W., R.S., H.A., K.J.K.); and Department of Radiology, University of Wisconsin, Madison (H.J.W.). Received October 23, 2001; revision requested January 14, 2002; final revision received July 2; accepted July 17. Address correspondence to H.J.W. (e-mail: wagnerh@med.uni-marburg.de).

PURPOSE: To determine in a prospective controlled trial the effect of percutaneous transluminal angioplasty (PTA) on skin oxygen supply and microcirculation as measured by means of transcutaneous oxygen pressure in patients with disabling lower-limb ischemia compared with that in patients who underwent intraarterial angiography for the assessment of disabling lower-limb ischemia.

MATERIALS AND METHODS: Thirty-four patients (17 men, 17 women; mean age, 68.6 years ± 9.8 [SD]) with peripheral arterial occlusive disease (PAOD) (claudication, n = 15; critical ischemia, n = 19) underwent transcutaneous oxygen pressure measurement at the dorsum of the foot 1 day before PTA, during PTA, 1 day after PTA, and 6 weeks after PTA. Measurements were obtained with the patient in the supine and erect sitting positions, as well as after exercise. Thirty-one patients (21 men, 10 women; mean age, 68.5 years ± 9.3) with symptomatic PAOD who were undergoing intraarterial angiography served as the control group.

RESULTS: Mean pressure before PTA was 31.6 mm Hg ± 24 in the supine position, 50.8 mm Hg ± 22 in the sitting position, and 22.2 mm Hg ± 23 after exercise. Immediately after PTA, a significant increase to 34 mm Hg ± 20 in the supine position was noted (P < .05). One day after PTA, pressure was 37.3 mm Hg ± 20 for the supine position and 52 mm Hg ± 20 for the sitting position. Six weeks after treatment, a further significant increase to 43.9 mm Hg ± 19 in the supine position, 61 mm Hg ± 15 in the sitting position, and 44.7 mm Hg ± 24 after exercise was noted (P < .05). In the control group, a significant pressure decrease immediately after and 1 day after angiography was noted (P < .05). Measurements returned to baseline at 6 weeks follow-up.

CONCLUSION: PTA has a positive effect on oxygen supply to the skin in patients with PAOD. Conversely, intraarterial angiography in patients with PAOD deteriorates skin microcirculation temporarily.

© RSNA, 2003

Index terms: Arteries, extremities, 928.128 • Arteries, transluminal angioplasty, 928.128 • Blood, flow dynamics • Contrast media, effects • Oxygen