Transcutaneous Oxygen Pressure Measurements on the Buttocks During Exercise to Detect Proximal Arterial Ischemia

Ábrahám, Pierre; Picquet, Jean; Vielle, Bruno; Sigaudo‐Roussel, Dominique; Paisant-Thouveny, Francine; Enon, B; Saumet, J. L.

doi:10.1161/01.cir.0000060500.60646.e0

Cited by 132 publications

(163 citation statements)

References 30 publications

(54 reference statements)

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“…4 Ex-tcPO2 performed by a single trained operator was compared against arteriography. 5 An objectively determined cut-off point for the presence of arteriographic lesions was a lowering in the decrease from rest of oxygen pressure (DROP) below −15 mmHg. 6 External validation of the technique and confirmation of this cut-off limit with CTA, and performance by various moderately trained or untrained operators, has never been reported.…”

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confidence: 99%

Exercise Transcutaneous Oximetry of the Buttocks　― External Validation With Computed Tomography Angiography ―

Audonnet

Signolet

Colas-Ribas

et al. 2017

Circ J

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Background: Exercise transcutaneous oximetry (Ex-tcPO2) is a non-invasive test for exercise-induced buttock ischemia. Prior study defined Ex-tcPO2 normal/abnormal cut-offs against arteriography but no external validation was available. The aims of this study were therefore to (1) determine the diagnostic performance of Ex-tcPO2 against CTA; (2) determine the cut-off point for detection of stenosis >75% in arteries toward the hypogastric circulation; and (3) determine the effect of chest profile classification on the diagnostic performance of Ex-tcPO2. Methods and Results:A total of 207 patients referred for Ex-tcPO2 were analyzed. DROP during Ex-tcPO2 was compared with the CTA results. Chest-tcPO2 changes were automatically classified into pre-defined profiles representing normal or abnormal responses. Using DROP <−15 mmHg as a cut-off, Ex-tcPO2 had 80.2% sensitivity, 72.3% specificity, 43.1% PPV, 93.3% NPV and 73.9% accuracy, to detect 1 stenosis >75% in arteries toward the hypogastric circulation. Optimal DROP to detect stenosis was: −15 mmHg. The overall diagnostic performance of Ex-tcPO2 was independent of chest profile classification. Conclusions:Ex-tcPO2 has satisfactory diagnostic performance to detect arterial stenoses towards the hypogastric circulation. Abnormal chest-tcPO2 profile does not impair the overall diagnostic performance of the test.

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confidence: 99%

Exercise Transcutaneous Oximetry of the Buttocks　― External Validation With Computed Tomography Angiography ―

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Colas-Ribas

et al. 2017

Circ J

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“…Ex-tcpO 2 results confirm that it is not the case and the buttock pain clearly results from a worsening of buttock ischemia during exercise. Since 2003, the analysis of Ex-tcpO 2 results with the DROP index has allowed to get rid of the reliability issue of absolute tcpO 2 values and has attained highly reliable exercise results in claudicants [2]. As shown in the figure, Ex-tcpO 2 provides objective evidence that angioplasties have normalized the perfusion both on the right and left thigh as a result of technically successful angioplasties, while right buttock ischemia is almost unchanged.…”

Section: Discussionmentioning

confidence: 99%

“…From tcpO 2 recorded values, we automatically calculated the decrease from rest of oxygen pressure (DROP) at each limb site. The DROP index had been described and validated [2,3]. The DROP index consists in the subtraction of limbtcpO 2 changes from chest tcpO2-changes.…”

Section: Case Descriptionmentioning

confidence: 99%

“…Transcutaneous oxygen pressure during exercise (Ex-tcpO 2 ) can be used to monitor exercise-induced regional blood flow impairment (RBFI) throughout walking treadmill tests on both lower limbs and different areas. This method was demonstrated to be accurate to detect arteriographically proved lesions [2]. Thereby Ex-tcpO 2 is a unique tool to determine the concordance between symptoms and arterial lesions shown by imaging.…”

Section: Introductionmentioning

confidence: 96%

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Exercise Oxymetry in the Diagnosis of a Clinically Challenging Bilateral Socket Intolerance and Follow-up of An Apparently Inefficient Revascularisation

Henni¹,

Ábrahám²

2017

Int J Phys Med Rehabil

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Socket intolerance is a cause of walking impairment in amputees. Exercise transcutaneous oxygen pressure (ExtcpO 2 ) is proposed to monitor exercise-induced ischemia. A man with bilateral tibial amputation was referred for left thigh pain and socket intolerance. Ex-tcpO 2 showed an ischemia on the left thigh and on buttocks. After vascular surgery, the patient complains from walking limitation with left buttock pain. A new Ex-tcpO 2 showed a normalization of the thighs ischemia but a worsening on the left buttock, due to the circumflex artery occlusion during surgery. This case illustrates questions that physician may face, Ex-tcpO 2 confirms vascular origin of the pain.

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“…The pelvic circulation has been examined by transcutaneous oxygen pressure (tcp02) and near infrared spectroscopy (NIRS) [8][9][10][11][12]. The latter technique has proven useful for assessment of changes of regional cerebral oxygen saturation [13], in vascular surgical patients [14] and in evaluation of patients with peripheral arterial disease [15].…”

Section: Introductionmentioning

confidence: 99%

Hemodynamic Consequences of Internal Iliac Artery Occlusion Following Endovascular Abdominal Aortic Aneurysm Repair Assessed by Near-Infrared Spectroscopy

Taudorf¹,

Nielsen²,

Nielsen³

et al. 2018

Preprint

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The purpose was to evaluate endovascular aortic repair (EVAR) patients with known gluteal claudication using near infrared spectroscopy (NIRS), and secondly to assess the hemodynamic consequences of occluding one internal iliac artery (IIA) during EVAR.EVAR interventions with occlusion of one IIA were examined. Gluteal claudicants were recruited from the outpatient clinic at their annual EVAR control (Group A; n=7) and a second cohort was collected consecutively and prospectively before and after the intervention (Group B; n=10). A treadmill test (12% incline, 2.4 km/h) with NIRS (INVOS-5100) sensors applied bilaterally on the gluteal regions was performed. NIRS was used to asses muscle oxygenation. NIRS data was divided into baseline, exercise and recovery values. Recovery times and absolute NIRS values (oxygenation) from the two gluteal sides were compared.Mean recovery times (group A) of the occluded and patent sides were 512 sec and 137 sec [0-643] (p=0.046) respectively. Using 240 seconds (suggested by literature) as cut-off the sensitivity and specificity were both 71% for finding the occluded IIA. Group B revealed similar oxygenation level of the two gluteal regions pre EVAR. Post EVAR an overall absolute reduction of the oxygenation were noted and a significant difference in the recovery values of the two gluteal sides (p<0.05).In this explorative study NIRS does show relevant changes of the oxygenation on the gluteal region following occlusion of an IIA in groups of patients. But given the lack of statistical power the efficacy of diagnostic use in individual patients has yet to be proven.

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Transcutaneous Oxygen Pressure Measurements on the Buttocks During Exercise to Detect Proximal Arterial Ischemia

Cited by 132 publications

References 30 publications

Exercise Transcutaneous Oximetry of the Buttocks　― External Validation With Computed Tomography Angiography ―

Exercise Transcutaneous Oximetry of the Buttocks　― External Validation With Computed Tomography Angiography ―

Exercise Oxymetry in the Diagnosis of a Clinically Challenging Bilateral Socket Intolerance and Follow-up of An Apparently Inefficient Revascularisation

Hemodynamic Consequences of Internal Iliac Artery Occlusion Following Endovascular Abdominal Aortic Aneurysm Repair Assessed by Near-Infrared Spectroscopy

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Transcutaneous Oxygen Pressure Measurements on the Buttocks During Exercise to Detect Proximal Arterial Ischemia

Cited by 132 publications

References 30 publications

Exercise Transcutaneous Oximetry of the Buttocks ― External Validation With Computed Tomography Angiography ―

Exercise Transcutaneous Oximetry of the Buttocks ― External Validation With Computed Tomography Angiography ―

Exercise Oxymetry in the Diagnosis of a Clinically Challenging Bilateral Socket Intolerance and Follow-up of An Apparently Inefficient Revascularisation

Hemodynamic Consequences of Internal Iliac Artery Occlusion Following Endovascular Abdominal Aortic Aneurysm Repair Assessed by Near-Infrared Spectroscopy

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Exercise Transcutaneous Oximetry of the Buttocks　― External Validation With Computed Tomography Angiography ―

Exercise Transcutaneous Oximetry of the Buttocks　― External Validation With Computed Tomography Angiography ―