Exercise Transcutaneous Oxygen Pressure (Extcpo2) Measurement is a Reliable Method of Evaluation of Internal Iliac Artery flow Compromise

Clinical differentiation of buttock claudication from pseudo-claudication (neuromuscular etiology) is often challenging and cannot be diagnosed non-invasively using standard ankle-brachial index (ABI) with exercise. The aim this study was to evaluate the reliability exercise transcutaneous oximetry (ExTcPO2) accurately detect significant internal iliac artery (IIA) inflow stenosis. Methods: Data a prospectively maintained registry consecutive patients undergoing ExTcPO2 for evaluation hip exertional discomfort as well arterial imaging within 12 months were retrospectively analyzed. performed on treadmill (10% slope; 2 mph speed); measured at buttocks, upper back calf (rest, exercise) document baseline normal, degree change recovery patterns. A Delta Resting Oxygen Pressure (DROP) (buttock- TcPO2 mmHg) ≥15 mm Hg considered significant. blinded physician aorto-iliac stenosis quantification receiver operating characteristic (ROC) curve analysis used determine sensitivity specificity diagnose severe reduction (≥70%) based upon diagnostic DROP Hg. Results: One hundred eleven (M:F::79:32, mean age 70, range 18-90 years) available concomitant (CTA 90, DUS 21) included in study. Indications testing suspected vascular (82), or neuromuscular (29) symptoms. confirmed clinical suspicion state IAA 81% (91/111) patients. had sensitivity, specificity, PPV, NPV 56, 80, 68% respectively prediction IIA (p value <0.001; OR 1.116, 95% CI 1.057-1.157; C- statistic 0.76, SE=0.03). Aorto-iliac reconstruction treat flow compromise 16 Revascularization Direct Antegrade (IIA PTA /stenting – 4, aorto-ilac stenting /endarterectomy 9), Retrograde (aorto-biiliac bypass) 1 Indirect via increased collateral (profundoplasty) 3. Post-operatively symptom relief noted 15/16 objectively demonstrated ExTcPo2 6/7 (Figure 2). patient did not improve clinically, EXTcPO2 following revascularization. Conclusion: Exercise can reliably It simple, non-invasive serve valuable screening tool differentiate other causes low back, post-operatively confirm adequacy revascularization conjunction standard, noninvasive ABI.