Key result
Transcutaneous oxygen tension measurement on the buttocks during exercise detected proximal arterial ischemia with 83% sensitivity and 82% specificity in patients with suspected ischemia.
Why the study?
Does transcutaneous oxygen tension measurement on the buttocks during exercise accurately detect proximal arterial ischemia in vascular patients?
Observational (n=77)
Does transcutaneous oxygen tension measurement on the buttocks during exercise accurately detect proximal arterial ischemia in vascular patients?
Effect estimate: 83% sensitivity and 82% specificity in suspected patients; 79% sensitivity and 86% specificity in non-suspected patients
p-value: p=<0.0001
Transcutaneous oxygen pressure measurement on the buttocks during exercise is a sensitive and specific noninvasive method for detecting proximal arterial ischemia.
Supports noninvasive proximal ischemia detection; leaves open prospective validation before clinical adoption.
BACKGROUND: We sought to identify whether transcutaneous oxygen tension (tcPo2) measurements could be used to noninvasively detect lesions in the arterial network supplying blood flow to the hypogastric circulation. METHODS AND RESULTS: A study was undertaken in vascular patients with suspected (PC, n=43) and not with suspected (NPC, n=34) proximal ischemia. TcPo2 was measured on both buttocks and with a chest reference electrode. Arteriography on the right or left side was positive for stenoses (> or =75%) or occlusion of one or more of the following arteries: the aorta, the common iliac arteries, or the internal iliac arteries. The arteriography was compared with the resting tcPo2 values (REST) and with the minimal value (MIN) and maximal change from rest normalized to eventual chest changes (DROP) recorded during or after a treadmill test. REST, MIN, and DROP were, respectively, as follows in positive versus negative arteriograms (mean+/-SD; in mm Hg): 80.2+/-10.9 versus 78.6+/-11.5 (P>0.05), 55.2+/-20.0 versus 69.9+/-15.8 (P<0.001), and -31.8+/-17.6 versus -9.5+/-6.4 (P<0.0001) in PC and 78.9+/-14.0 versus 80.5+/-14.3 (P>0.05), 64.4+/-21.0 versus 75.1+/-14.6 (P<0.02), and -24.1+/-13.5 versus -8.7+/-4.8 (P<0.0001) in NPC. In PC and NPC respectively, with a cutoff point of -16 and -15 mm Hg, DROP showed, respectively, 83%/82% and 79%/86% sensitivity/specificity in the diagnosis of positive arteriograms. CONCLUSIONS: Proximal ischemia is a frequent finding in vascular patients. TcPo2 measurement on the buttocks during exercise is a sensitive and specific indicator for lesions in the arterial tree toward the hypogastric circulation. Potentially it could objectively assess the response to endovascular or surgical approaches to iliac lesions.
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Abraham et al. (2003) conducted an observational in Suspected and not suspected proximal arterial ischemia (n=77). Transcutaneous oxygen tension (tcPo2) measurements on buttocks during exercise vs. Arteriography (reference standard) was evaluated on Detection of stenoses (≥75%) or occlusion in the aorta, common iliac, or internal iliac arteries (83% sensitivity and 82% specificity in suspected patients; 79% sensitivity and 86% specificity in non-suspected patients, p=<0.0001). Transcutaneous oxygen tension measurement on the buttocks during exercise detected proximal arterial ischemia with 83% sensitivity and 82% specificity in patients with suspected ischemia.
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