CardioVascular and Interventional Radiology

, Volume 34, Issue 2, pp 271–279 | Cite as

Superiority of Transcutaneous Oxygen Tension Measurements in Predicting Limb Salvage After Below-the-Knee Angioplasty: A Prospective Trial in Diabetic Patients With Critical Limb Ischemia

  • Ulf Redlich
  • Yan Y. Xiong
  • Maciej Pech
  • Jörg Tautenhahn
  • Zuhir Halloul
  • Ralf Lobmann
  • Daniela Adolf
  • Jens Ricke
  • Oliver DudeckEmail author
Clinical Investigation



To assess postprocedural angiograms, the ankle–brachial index (ABI), and transcutaneous oxygen tension (TcPO2) to predict outcome after infrageniculate angioplasty (PTA) in diabetic patients with critical limb ischemia (CLI) scheduled for amputation.

Materials and Methods

PTA was performed in 28 diabetic patients with CLI confined to infrapopliteal vessels. We recorded patency of crural vessels, including the vascular supply of the foot as well as the ABI and TcPO2 of the foot.


Technical success rate was 92.9% (n = 26), and limb-salvage rate at 12 months was 60.7% (n = 17). The number of patent straight vessels above and below the level of the malleoli increased significantly in patients avoiding amputation. Amputation was unnecessary in 88.2% (n = 15) patients when patency of at least one tibial artery was achieved. In 72.7% (n = 8) of patients, patency of the peroneal artery alone was not sufficient for limb salvage. ABI was of no predictive value for limb salvage. TcPO2 values increased significantly only in patients not requiring amputation (P = 0.015). In patients with only one tibial artery supplying the foot or only a patent peroneal artery in postprocedural angiograms, TcPO2 was capable of reliably predicting the outcome.


Below-the-knee PTA as an isolated part of therapy was effective to prevent major amputation in more than a half of diabetic patients with CLI. TcPO2 was a valid predictor for limb salvage, even when angiographic outcome criteria failed.


Ankle–brachial index Below-the-knee angioplasty Critical limb ischemia Diabetes Major amputation Postprocedural angiogram Transcutaneous oxygen tension 


Conflicts of interest

There are no conflicts of interest.


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Copyright information

© Springer Science+Business Media, LLC and the Cardiovascular and Interventional Radiological Society of Europe (CIRSE) 2010

Authors and Affiliations

  • Ulf Redlich
    • 1
    • 2
  • Yan Y. Xiong
    • 1
  • Maciej Pech
    • 1
  • Jörg Tautenhahn
    • 3
  • Zuhir Halloul
    • 3
  • Ralf Lobmann
    • 4
    • 5
  • Daniela Adolf
    • 6
  • Jens Ricke
    • 1
  • Oliver Dudeck
    • 1
    Email author
  1. 1.Department of Radiology and Nuclear MedicineUniversity of MagdeburgMagdeburgGermany
  2. 2.Department of RadiologyHarz Klinikum WernigerodeWernigerodeGermany
  3. 3.Department of Vascular SurgeryUniversity of MagdeburgMagdeburgGermany
  4. 4.Department of EndocrinologyUniversity of MagdeburgMagdeburgGermany
  5. 5.Department of Endocrinology, Diabetology, and GeriatyKlinikum Stuttgart, BürgerhospitalStuttgartGermany
  6. 6.Institute of Biometry and Medical InformaticsUniversity of MagdeburgMagdeburgGermany

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