Predictive value of preoperative segmental blood pressure measurements in below-knee amputations

Segmental blood pressure criteria for below-knee amputations were assessed retrospectively. 40 patients underwent 44 below-knee amputations for advanced lower limb ischaemia. Preoperative systolic blood pressure measurements using a Doppler device as a distal sensor were performed on 31 limbs to be amputated. Healing occurred in all limbs with calf systolic pressures of 68 mmHg or more and distal thigh systolic pressures of 100 mmHg or more. With calf pressures below 35 mmHg and distal thigh pressures of 60 mmHg or less, all amputations failed. Diabetes did not affect the pressure criteria except for one obvious case with mediasclerosis. It appeared that pressure data could be used to improve the preoperative assessment of the amputation level.