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In Arterial Occlusive Disease

Thomas F. O'Donnell, Jr, MD; Jeffrey K. Raines, PhD; R. Clement Darling, MD

Arch Surg. 1979;114(5):600-604.

Abstract
• To examine the possible relationship between Doppler pressures (DP) and pulse volume amplitude (PVR) with muscle surface pH (pHm), we studied 20 patients before, during, and after arterial reconstruction. The mean pHm for the claudication, rest pain, and ischemic gangrene groups differed from a control group and from each other. The pHm varied directly with DP and PVR for the 20 patients as a whole. After reconstructive surgery, improvement in pHm seemed to precede changes in DP and PVR in six patients with combined segment disease. Although pHm correlates generally with DP and PVR, it is invasive. Therefore, pHm should not be used as a routine screening test. Whereas DP and PVR may reflect the anaerobic activity of peripheral tissue, they may be less prompt than pHm in responding to acute changes in blood flow.

(Arch Surg 114:600-604, 1979)

Author Affiliations
From the Surgical Services and the Vascular Laboratory, Massachusetts General Hospital, Harvard Medical School (Drs O'Donnell, Raines, and Darling); and the Department of Surgery and Noninvasive Vascular Laboratory, Tufts-New England Medical Center, Tufts University School of Medicine (Dr O'Donnell); Boston.

Footnotes
Accepted for publication Dec 11, 1978.

Read in part before the Tissue pH and Oxygen Monitoring Workshop, Peter Bent Brigham Hospital, Boston, May 3, 1977.

Reprint requests to Department of Surgery, Tufts-New England Medical Center, 171 Harrison Ave, Boston, MA 02111 (Dr O'Donnell).

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