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- W2033929284 abstract "Systolic ankle and toe pressure measurements are considered to be the best way of documenting arterial occlusive disease. In the European consensus, chronic critical limb ischaemia is defined as persistent pain with an ankle pressure lower than 50 mmHg. To investigate the possible adjunct value of microcirculatory assessment, capillary microscopy and transcutaneous oximetry were performed in 21 asymptomatic persons (F1), 89 claudicants (F2) and 54 patients with critical limb ischaemia (F314). Capillary morphology (diameter, density) and dynamics (red blood cell velocity (RBCV), peak RBCV and time to peak RBCVI, as well as transcutaneous oximetry parameters were determined for each Fontaine group and compared with ankle and toe pressure measurements. Despite considerable overlap, ankle and toe pressures were significantly (p < 0.001) different between F1, F2 and F3/4 patients. Capillary density (p < 0.05), diameter (p < 0.05), peak RBCV (p < 0.05) and time to peak RBCV (p < 0.01), as well as transcutaneous oximetry parameters (p < 0.001) were significantly different between all groups and impaired with progression of ischaemia. However, a similar overlap between all groups was observed, except the supine TcpO2 parameter which separated F3/4 patients completely from the other groups. In all patients with critical limb ischaemia, dynamic parameters, such as peak RBCV (p < 0.01) and time to peak RBCV (p < 0.001), were significantly lower as compared to non-critically ischaemic patients, irrespective of an ankle pressure below or above a value of 50 mmHg, illustrating the additional value of microcirculatory assessment in these patients. In conclusion, in patients with moderate or severe limb ischaemia, microcirculatory assessment is not superior to ankle or toe pressure measurements. In patients with critical limb ischaemia, however, in whom capillary nutritional blood flow is compromised, microcirculatory investigation provides additional information. Therefore, vascular reconstructive surgery is likely to be indicated in these patients, despite an ankle pressure above 50 mmHg." @default.
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- W2033929284 date "1992-03-01" @default.
- W2033929284 modified "2023-09-26" @default.
- W2033929284 title "Assessment of the microcirculation provides additional information in critical limb ischaemia" @default.
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- W2033929284 doi "https://doi.org/10.1016/s0950-821x(05)80230-0" @default.
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