Near-infrared spectroscopy in the routine diagnostic work-up of patients with leg ischaemia.

OBJECTIVE To examine the reproducibility and clinical applicability of near-infrared spectroscopy (NIRS) in patients with leg ischaemia. DESIGN Prospective comparative diagnostic study. MATERIALS AND METHODS Routinely measured peripheral blood pressure and microcirculatory parameters were compared with tissue oxygen saturation (TsO(2)) measurements using a new NIRS device on the calf muscle and the foot. Healthy subjects (n=20) and patients in different stages of leg ischaemia (n=45) were investigated at rest and after provocation: a treadmill test, arterial occlusion and a change in posture. Healthy volunteers were used as an age-matched reference population. RESULTS Reproducibility of the NIRS was excellent (intraclass correlation coefficient at rest was 0.91 (95% confidence interval: 80-99). Resting TsO(2) (65%) in healthy controls did not differ significantly from that in patients (Fontaine 2: 66%; F3/4: 68%). After exercise, a significant reduction in TsO(2) was observed only in patients: Fontaine 1: 60%; Fontaine 2: 21%, Fontaine 3/4: 29%. The ankle/brachial index after exercise showed a good correlation (R=0.73) with TsO(2) at the end of the treadmill test. No correlation between NIRS and other micro- or macrocirculatory parameters was found. CONCLUSION NIRS is a very reproducible tool to assess tissue oxygen saturation, but is not useful for the routine work-up of patients with leg ischaemia.

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