Assessing Microcirculation for Predictive Purposes with the Aim of Reducing the Amputation Rate in the Case of Patients with Critical Lower Limb Ischemia

摘要

The aim of the present study is to assess the role of the partial pressure of tissue oxygen with the purpose of having a prediction on the healing capacity of peripheral tissues affected by critical ischemia. As far as material and method are concerned, the study extended over a two-year period, broken up into three distinctive stages. A total of 198 patients diagnosed with critical ischemia in the lower limbs, in accordance with the TASC II definition, were enrolled and then divided into four groups: group 1: primary amputees; group 2: repeat amputees; group 3: revascularized patients; and group 4: unsuccessfully revascularized patients. Results: in the first stage, it was noted that the percentage of amputees was extremely high (75%), as compared to the percentage of revascularized patients (25%), and a large number of repeat amputees were also noted. The latter patient category is associated with a large number of days of hospitalization and high costs. By using the measurement of the partial pressure of tissue oxygen (TcP02) as a matter of routine, it was possible to significantly lower the number of primary amputees (57%) and to raise the number of revascularized patients (43%), as compared to the first stage. Also, by assessing microcirculation, it was possible to use certain objective data on the healing capacity of the tissue, so that we no longer had any repeat amputees. Conclusion: Microcirculation is deeply affected in critical ischemia and the assessment thereof is important in raising the quality of life in the case of patients with critical ischemia.