Outcomes of Endovascular Intervention and Bypass Surgery for Femoral Artery Atherosclerosis

Utility of digital pulse oximetry in the screening of lower extremity arterial disease

Purpose

The aim of this study was to evaluate screening methods in the lower extremities by measurement of the digital pulse oximetry (oxygen percent saturation [SpO₂]) of toes for peripheral arterial disease (PAD).

Methods

A prospective study was performed among 49 patients (98 limbs) with lower extremity arterial occlusive disease. We attempted to measure the ankle-brachial index (ABI), digital pulse oximetry (SpO₂), and computerized tomographic angiography (CTA). Patients were divided into three groups by the traditional Fontaine classification system by symptom and CTA criteria: 1) Critical limb ischemia (Fontaine III and IV), 2) Claudication; (Fontaine II), and 3) asymptomatic limbs (Fontaine I).

Results

The sensitivity, specificity, positive and negative predictive values between active treatment groups (group I and II; endovascular and open surgery) and conservative group (group III) are all statistically significant. ABI; 55.09%, 94%, 96.7%, 39.02% (R = 12.54, P < 0.000) SpO₂; 87.06%, 87.8%, 84.3%, 90% (R = 40.11, P < 0.000). Pre-SpO₂ and pre-ABI all show statistically significant correlation in group I vs. group II, symptomatic PAD (group I and II) vs. asymptomatic PAD (group III), and the total PAD comparison. The Pearson's correlation coefficient between SpO₂ and ABI all show significant correlation in group II. Pre-SpO₂ vs. Pre-ABI show strong positive correlation except asymptomatic group (group III).

Conclusion

Digital pulse oximetry can be a useful, simple, noninvasive screening device as well as ABI in PAD.