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Computerized Dynamic Posturography for Postural Control Assessment in Patients with Intermittent Claudication
Published on: December 11, 2013
'Pole test' measurements in critical leg ischaemia
N Paraskevas1, R Ayari, S Malikov
1Department of Vascular Surgery, La Timone Hospital, Marseille, France. nparaskevas@yahoo.com
Summary
The pole pressure test accurately detects critical limb ischemia (CLI), showing higher sensitivity than traditional cuff-manometry and transcutaneous oxygen pressure (TcPO2) measurements. This method offers a reliable diagnostic tool for CLI, particularly in diabetic patients.
Area of Science:
- Vascular Surgery
- Diagnostic Imaging
- Peripheral Artery Disease
Background:
- Current methods for quantifying critical limb ischemia (CLI), such as cuff-manometry and transcutaneous oxygen pressure (TcPO2), have limitations.
- Cuff-manometry can overestimate blood pressure in diabetic patients due to medial calcification, while TcPO2 measurements show overlap and questionable reproducibility.
- Arterial wall stiffness affects cuff-manometry and TcPO2, but has less influence on the pole test.
Purpose of the Study:
- To evaluate the diagnostic accuracy of the pole pressure test for critical lower limb ischemia.
- To compare the pole test results with established methods: cuff-manometry and TcPO2.
- To assess the correlation of the pole test with these methods, considering factors like diabetes.
Main Methods:
- A prospective study was conducted at a university hospital involving 74 patients (83 legs) with symptoms of CLI.
- Four diagnostic methods were employed: pole test, cuff-manometry, TcPO2, and arteriography.
- Critical limb ischemia was defined based on arteriographic findings combined with rest pain or tissue loss and specific ankle systolic pressure (ASP) or TcPO2 thresholds.
Main Results:
- The pole test demonstrated high accuracy (88%) for CLI detection, with 95% sensitivity and 73% specificity.
- Cuff-manometry measurements were significantly higher than pole test results, particularly in diabetic patients.
- While correlations were observed between the pole test and TcPO2 in diabetic patients, and between the pole test and cuff-manometry in non-diabetics, no correlation was found between cuff-manometry and TcPO2.
Conclusions:
- The pole pressure test is a highly sensitive and accurate method for diagnosing critical limb ischemia.
- It offers advantages over traditional cuff-manometry and TcPO2, especially in patients with arterial calcification and diabetes.
- The pole test provides a reliable, non-invasive tool for assessing CLI severity.
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