Comparison of Ankle Pressure, Systolic Toe Pressure, and Transcutaneous Oxygen Pressure to Predict Major Amputation After 1 Year in the COPART Cohort

Pierre Salaun; Iléana Desormais; François-Xavier Lapébie; Alessandra Bura Riviere; Victor Aboyans; Philippe Lacroix; Vincent Bataille; Joël Constans; Carine Boulon

Comparison of Ankle Pressure, Systolic Toe Pressure, and Transcutaneous Oxygen Pressure to Predict Major Amputation After 1 Year in the COPART Cohort

Pierre Salaun ¹ Iléana Desormais ^{2, 3, *} François-Xavier Lapébie ⁴ Alessandra Bura Riviere ⁵ Victor Aboyans ^{2, 3} Philippe Lacroix ^{2, 3} Vincent Bataille ⁶ Joël Constans ⁷ Carine Boulon ¹

* Auteur correspondant

1 Service de Cardiologie [CHU Bordeaux]

2 Service de Chirurgie Thoracique et Vasculaire - Médecine vasculaire [CHU Limoges]

3 NET - Neuroépidémiologie Tropicale

4 Service d'Accompagnement et Soins Palliatifs [CHU Limoges]

5 CHU Toulouse [Toulouse]

6 Service de cardiologie [Toulouse]

7 Imagerie Fonctionnelle et Métabolique en Oncologie

Abstract : 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.

Keywords : critical limb ischemia ankle pressure transcutaneous oxygen toe pressure peripheral arterial disease laser Doppler

Type de document :

Article dans une revue

Domaine :

Sciences du Vivant [q-bio] / Santé publique et épidémiologie

Liste complète des métadonnées

https://hal-unilim.archives-ouvertes.fr/hal-02042682
Contributeur : Elisabeth Grelier <>
Soumis le : mercredi 20 février 2019 - 15:14:26
Dernière modification le : vendredi 11 octobre 2019 - 20:22:58

Comparison of Ankle Pressure, Systolic Toe Pressure, and Transcutaneous Oxygen Pressure to Predict Major Amputation After 1 Year in the COPART Cohort

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Comparison of Ankle Pressure, Systolic Toe Pressure, and Transcutaneous Oxygen Pressure to Predict Major Amputation After 1 Year in the COPART Cohort

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