Zarejestruj się | Masz już konto? Zaloguj się

Estimation of parameters, obtained by non-invasive techniques, used to assess the extent of ischemia in patients with clinical manifestations of atherosclerotic stenosis of lower limbs’ arteries.
Jakub Tomaszewski, Emil Durka, Marek Konkol
Various parameters of lower limbs’ ischemia are used for diagnostic and prognostic purposes. Part of them can be performed in every physician’s office, the rest require more sophisticated devices, whereas the Laser Doppler method is only applicable for researches. There are plenty of difficulties connected with proper interpretation of those parameters and to find correlation with clinical manifestations.

Material and methods:
The study was performed on a group of 48 patients (31 men, 17 women, 68 y.o on average) hospitalized in Vascular Surgery Clinic PUMS with diagnosed arteriosclerosis of the lower limbs arteries. The control group included 15 patients on corresponding age range with arteriosclerotic changes ruled out. All the patients had a detailed history taken and physical examination performed. There were assessed the ankle-brachial index and the maximal systolic blood flow velocity of posterior tibial artery based on USG Duplex examination. Using the Laser Doppler-PeriFlux 5000 the average relative skin perfusion was measured. The patients were divided into groups depending on gained parameters.

Among the group of patients without diabetes the presence of direct correlation between the clinical symptoms, ABI value and the posterior tibial artery maximal flow velocity was revealed. However, within the patients presenting diabetes, such correlation was not found. Furthermore, a direct correlation between clinical symptoms, indexes and mean, relative cutaneous perfusion obtained in Laser Doppler test was not affirmed. Simultaneously, in some patients, despite poor test results and clinical symptoms a good cutaneous perfusion was affirm.

A reliable characterization of indexes, determining the limb ischemia extent, requires experience and accuracy. Perfusion assessment using Laser Doppler and maximal flow velocity evaluation in posterior tibial artery cause especially many problems. Estimation of ABI brings the least difficulties. Affirmed lack of correlation confirms the thesis that final assessment should be based on clinician’s experience. Finally, none of parameters fulfill the criteria of the “ideal parameter”.
Skomentuj ten artykuł:
Zaloguj się aby dodać swój komentarz.
Komentarze do tego artykułu:
Nikt nie skomentował jeszcze tego artykułu