Published Online
on March 31, 2003

A more recent version of this article appeared on April 15, 2003

This Article Full Text (PDF) All Versions of this Article: 107/14/1896    most recent 01.CIR.0000060500.60646.E0v1 Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Permissions Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Abraham, P. Articles by Saumet, J.-L. Search for Related Content PubMed PubMed Citation Articles by Abraham, P. Articles by Saumet, J.-L. Related Collections Cardiovascular imaging agents/Techniques Exercise testing Other diagnostic testing CV surgery: aortic and vascular disease

Submitted on October 26, 2002
Revised on January 16, 2003
Accepted on January 17, 2003

Transcutaneous Oxygen Pressure Measurements on the Buttocks During Exercise to Detect Proximal Arterial Ischemia. Comparison With Arteriography

Pierre Abraham MD, PhD^*, Jean Picquet MD, Bruno Vielle MD, Dominique Sigaudo-Roussel PhD, Francine Paisant-Thouveny MD, Bernard Enon MD, PhD, and Jean-Louis Saumet MD, PhD

From the Departments of Vascular Studies (P.A., J.-L.S.), Vascular Surgery (J.P., B.E.), Physiology (D.S.-R.), Biostatistics (B.V.), and Radiology (F.P.-T.), University Hospital of Angers, France.

^* To whom correspondence should be addressed. E-mail: Piabraham{at}chu-angers.fr.

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 (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.

Key words: peripheral vascular disease • diagnosis • claudication • regional blood flow • exercise

This article has been cited by other articles:

				G. Mahe, G. Leftheriotis, J. Picquet, V. Jaquinandi, J. L. Saumet, and P. Abraham A normal penile pressure cannot rule out the presence of lesions on the arteries supplying the hypogastric circulation in patients with arterial claudication Vascular Medicine, November 1, 2009; 14(4): 331 - 338. [Abstract] [PDF]

				A. Le Faucheur, P. Abraham, V. Jaquinandi, P. Bouye, J. L. Saumet, and B. Noury-Desvaux Measurement of Walking Distance and Speed in Patients With Peripheral Arterial Disease: A Novel Method Using a Global Positioning System Circulation, February 19, 2008; 117(7): 897 - 904. [Abstract] [Full Text] [PDF]

				D. Duerschmied, L. Olson, M. Olschewski, A. Rossknecht, G. Freund, C. Bode, and C. Hehrlein Contrast ultrasound perfusion imaging of lower extremities in peripheral arterial disease: a novel diagnostic method Eur. Heart J., February 1, 2006; 27(3): 310 - 315. [Abstract] [Full Text] [PDF]

				V. Jacquinandi, P. Bouye, J. Picquet, G. Leftheriotis, J.-L. Saumet, and P. Abraham Pain description in patients with isolated proximal (without distal) exercise-related lower limb arterial ischemia Vascular Medicine, November 1, 2004; 9(4): 261 - 265. [Abstract] [PDF]

				S. Manabe, N. Tabuchi, M. Toyama, T. Yoshizaki, M. Kato, H. Wu, M. Kotani, and M. Sunamori Oxygen pressure measurement during grip exercise reveals exercise intolerance after radial harvest Ann. Thorac. Surg., June 1, 2004; 77(6): 2066 - 2070. [Abstract] [Full Text] [PDF]