Usefulness of skin perfusion pressure for dialysis-associated steal syndrome

DOI Web Site Web Site 5 References

Bibliographic Information

Other Title
  • バスキュラーアクセス関連スチール症候群に対する皮膚灌流圧測定の有用性
  • バスキュラーアクセス カンレン スチール ショウコウグン ニ タイスル ヒフカンリュウアツ ソクテイ ノ ユウヨウセイ

Search this article

Abstract

 【Background and Purpose】Steal syndrome is diagnosed by integrating the objective findings and subjective symptoms. Since a serious ischemic symptom is accompanied by an ulcer, necrosis or irreversible neuropathy nerve paralysis, an objective rating method with high diagnostic capability is required. In severe ischemia of the lower limbs, it is reported that the measurement of skin perfusion pressure (SPP) is useful and is used for the decision on treatment policy and the judgment of the prognostic healing ability clinically. In this study, we examined the usefulness of SPP for dialysis-associated steal syndrome. 【Subjects and Methods】This study involved 106 patients with vascular access obtained by measuring the SPP at our clinic. By an interview on the presence of steal symptoms during an examination, subjects were classified into four groups of Stage I~IV by Fontaine's severity classification, with an additional fifth group without symptoms. The average values of SPP in the five groups were computed. Moreover, the subjects were classified according to the existence of steal condition, and the cut-off value was computed using cumulative relative frequency. 【Results】Among the subjects, 43 patients did not have steal condition and 63 patients did. In terms of the mean SPP level of each group, that of the symptomless group was 85.8±25.0 mmHg (44 cases), Stage I group 48.4±11.7 mmHg (28 cases), Stage II group 35.8±13.5 mmHg (17 cases), Stage III group 24.7±10.0 mmHg (16 cases), and Stage IV group 17.3±2.4 mmHg (3 cases). The cut-off value of steal syndrome generated using the cumulative relative frequency was 57.5 mmHg (sensitivity : 87.1%, specificity : 95.3%, positive likelihood : 18.2). 【Conclusions】SPP has high ability to diagnose steal syndrome and is useful as an objective laboratory procedure for investigating the condition of a patient.

Journal

References(5)*help

See more

Keywords

Details 詳細情報について

Report a problem

Back to top