Diagnostic value of ankle peak systolic velocity in diabetic patients with critical limb ischemia

Abstract

AIM: To evaluate the diagnostic value of ankle peak systolic velocity (APSV) in diabetic patients diagnosed with critical limb ischaemia (CLI) and its resolution after percutaneous transluminal angioplasty (PTA). MATERIALS AND METHODS: Forty-eight diabetic patients with CLI were included in this study. CLI was diagnosed according to the IWGDF 2015 criteria. Patients were examined before and 5–7 days after PTA with transcutaneous oxygen tension of the foot's soft tissues and APSV by duplex ultrasonography. RESULTS: The median transcutaneous oxygen tensions before and after PTA were 14 [3; 20.5] and 30 [18.5, 39.0] mmHg, respectively (p <0.001). The median APSV in diabetic patients with CLI was 10 [7.4; 15.5] cm/s before PTA and −46 [33.5, 59] cm/s after PTA (p <0.001). The APSV cutoff point for diabetic patients with CLI is ≤25.5 cm/s with a sensitivity of 79.4% [95% CI 62.1–91.3] and a specificity of 96.4% [95% CI 81.7–99.9]. CONCLUSIONS: APSV may be considered as an additional method for CLI assessment. Lower limb artery calcification, soft tissue oedema or infection and foot ulcer and gangrene influence the results of routine ischaemia diagnostic methods such as the ankle–brachial index, toe–brachial index, transcutaneous oximetry but not APSV.

Keywords

• critical limb ischemia
• diabetes mellitus
• transcutaneous oximetry
• ankle peak systolic velocity