Influence of low and moderate grade leg ischaemia on the skin microcirculation parameters in peripheral arterial occlusive disease patients

Abstract

Introduction. The aim of the study was to characterize the changes in the microcirculation in patients with varying severity of atherosclerotic ischaemia of the lower limbs (PAOD).

Material and methods. The study included 27 healthy subjects, 79 patients with PAOD category 0 and 1 according to the Rutherford classification, and 137 patients with PAOD category 3 and 4. The study evaluated cutaneous blood flow, flowmotion bonds, percutaneous partial pressure of oxygen and flow-mediated vasodilation.

Results. Even mild PAOD exhibits a worse systemic vascular function expressed as a reduction in the scope of flow-mediated vasodilation, and locally in TcpO2 decrease. Increase in local changes in advanced forms of PAOD were observed as further reduction in TcpO₂ and a drastic reduction or exhaustion of the functional microcirculatory reserve. Among the evaluated risk factors for atherosclerosis only diabetes and smoking significantly modified perfusion, which resulted in a significant decrease in the values of vasodilation and TcpO₂.

Conclusions. The study revealed the occurrence of adverse changes in microcirculation, also in patients with poorly discernible signs of limb ischaemia. It can be assumed that these may also occur in the patients who underwent a haemodynamically effective revascularization.