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The Journal of Cardiovascular Surgery 2000 December;41(6):897-904

Copyright © 2009 EDIZIONI MINERVA MEDICA

language: English

Piezoelectric pulse sensor device (Pulse Chek TM)-monitoring after the treatment of lower leg ischemia

Laine T., Zeitlin R., Salenius J. P.

From the Department of Surgery University Hospital, Tampere, Finland


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Background. The aim of ­this ­study was to eval­u­ate the use­ful­ness of the pie­zo­elec­tric ­pulse sen­sor ­device (Pulse ChekTM) as a con­tin­u­ous mon­i­tor­ing meth­od in ear­ly sur­veil­lance ­after the treat­ment of low­er leg ische­mia ­with ­either sur­gi­cal or inter­ven­tion­al pro­ce­dures.
Methods. Experimental ­design: pros­pec­tive ­study. Setting: insti­tu­tion­al prac­tice. Patients and inter­ven­tions: two ­patient ­groups ­with periph­er­al arte­ri­al occlu­sive dis­ease ­were includ­ed; a sur­gi­cal ­group under­go­ing femor­o­pop­li­teal ­bypass graft­ing (22 ­patients) and a ­group under­go­ing PTA of the femo­ral or pop­li­teal arter­ies (18 ­patients). Measures: the pie­zo­elec­tric ­pulse sen­sor was ­applied on the ­skin ­over the dor­sal­is ped­is ­artery. A base­line wave­form was record­ed pre­op­er­a­tive­ly and con­tin­u­ous mon­i­tor­ing ­begun imme­di­ate­ly ­after the sur­gi­cal or inter­ven­tion­al pro­ce­dure. Hard ­copy record­ings of the ­pulse ­wave ­were ­done in the imme­di­ate post­op­er­a­tive peri­od, the post­op­er­a­tive eve­ning, the fol­low­ing morn­ing or at any ­time the ­alarm was trig­gered. A ­late fol­low-up wave­form was record­ed ­after an aver­age of 34 ­days. Simultaneous ABI meas­ure­ments ­were record­ed.
Results. Preoperatively or pre-­inter­ven­tion, the ­pulse wave­form was accu­rate­ly record­ed in 15/22 (68%) ­patients in the sur­gi­cal ­group and 14/18 (78%) ­patients of the PTA ­group. In 20 (91%) sur­gi­cal ­group ­patients and in 14 (78%) PTA ­group ­patients, post­op­er­a­tive mon­i­tor­ing was reli­able, the ­pulse wave­form con­firmed paten­cy of the ves­sel. Piezoelectric ­pulse sen­sor ­device mon­i­tor­ing did not ­detect ­graft occlu­sion in ­only one ­patient in the sur­gi­cal ­group ­where inter­pre­ta­tion of the ­pulse ­wave was com­pli­cat­ed by a ­slow atri­al fib­ril­la­tion. There ­were 19 ­alarms in the ­pulse wave­form dur­ing mon­i­tor­ing for 11 (55%) sur­gi­cal ­group ­patients and 18 ­alarms for 9 (64%) PTA ­group ­patients. None of the ­alarms result­ed ­from ­graft occlu­sion. Reliable ­pulse wave­form record­ings ­were ­obtained in 16/21 (76%) sur­gi­cal ­group ­patients of the orig­i­nal 22 (one ­graft occlud­ed) and for 15/18 (83%) PTA ­group ­patients in the fol­low-up assess­ment ­after the ­mean 34 ­days. One sur­gi­cal ­patient was ­lost to fol­low-up.
Conclusions. The pie­zo­elec­tric ­pulse sen­sor ­device can be rec­om­mend­ed as a meth­od of con­tin­u­ous mon­i­tor­ing imme­di­ate­ly ­after the revas­cu­lar­iza­tion pro­ce­dure in ­those ­patients who ­have a ped­al ­artery ­where a reli­able ­pulse wave­form can be record­ed.

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