Noninvasive evaluation of peripheral vascular disease using transcutaneous oxygen tension

Transcutaneous oxygen tension (PtcO2) was used for noninvasive determination of blood supply in 25 patients evaluated for peripheral arterial disease. PtcO2 values were compared with segmental Doppler pressure, pulse volume recording, pulse reappearance time, and angiography in patients being evaluated for wound healing problems, amputations, and peripheral bypass procedures. PtcO2 was measured using a heated (45 degrees C) Clark polarographic electrode to quantitate the oxygen which diffuses from the dermal capillaries to the skin surface. Control PtcO2 values recorded over the chest or shoulder taken while patients were breathing room air were 78 +/- 8 mm Hg. PtcO2 values greater than 50 mm Hg predicted success for levels of amputation and for wound healing without reconstructive procedures; values of 40 mm Hg or less were associated with continued wound problems and complication after amputation. Increased PtcO2 values after vascular reconstruction of the legs predicted improved clinical status on follow-up examinations up to 6 months. PtcO2 predicted the extent of vascular disease as well as the other noninvasive tests and angiography. We conclude that (1) PtcO2 tension is a simple, accurate, noninvasive method to determine the appropriate level of amputation, wound healing potential, and effectiveness of bypass procedures, and (2) PtcO2 values correlate well with angiography and noninvasive evaluations.