Toe-brachial index and exercise test can improve the exploration of peripheral artery disease

Autor: Dóra Endrei, Barbara Sandor, David Kovacs, Kalman Toth, Beata Csiszar, Katalin Biro, Katalin Koltai, Dora Praksch, Gabor Kesmarky, I. Juricskay
Rok vydání: 2018
Předmět:
Zdroj: Atherosclerosis. 269:151-158
ISSN: 0021-9150
DOI: 10.1016/j.atherosclerosis.2018.01.023
Popis: Background and aims We assumed that hand-held Doppler ultrasound (DUS) at rest was insufficient to assess the severity of peripheral artery disease (PAD). Toe pressure and transcutaneous tissue oxygen pressure were studied to prove whether these could identify more patients with severe lower limb ischemia; exercise was applied to provoke ischemia. Methods 120 patients with PAD and 30 volunteers without PAD were recruited. DUS, transcutaneous tissue oxygen pressure (tcpO 2 ) and toe pressure measurements were performed at rest and after exercise. The differential power of these examinations for severe limb ischemia (SLI) was determined by receiver-operating curves (ROCs) and pattern recognition by independent multicategory analysis (PRIMA). Results There was an obvious significant difference between the patient and control groups at rest; after exercise; the ratio of severely impaired values (ankle-brachial index – ABI, toe-brachial index – TBI, tcpO 2 measured on index forefoot) increased significantly in the patient group ( p 2 , ABI measured after exercise could differentiate SLI better than the values of these tests at rest ( p 2 (AUC: 0.720) ( p Conclusions Pre- and post-exercise non-invasive vascular tests could reveal severe limb ischemia. Toe pressure measurement and TBI should become a basic part of the vascular workup.
Databáze: OpenAIRE
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