To the macro- and microcirculation on the fore foot under different compression pressure in patients suffering from peripheral arterial occlusive disease

Oedemas obstruct the nourishment of tissues in patients with peripheral art erial occlusive disease (PAOD). However, there is little information availa ble in the literature regarding the degree of compressive pressure ensuring a sufficient perfusion pressure without decreasing the macro- and microcir culation. Aim end method: The aim of this study was to determine the minimu m compressive pressure effecting a nontolerable impairment of the macro- an d microcirculation. The macrocirculation was measured by determining the an kle pressure using the ultra sound Doppler method. A total of 21 patients d iagnosed with PAOD and ankle pressure between 40 and 110 torr were included in the study. For the purposes of analysis the patients were divided into two groups: Group A (ankle pressure >65 torr) and Group B (ankle pressure < 65 torr). Result: Similar values were obtained in both groups for ankle pre ssure, tcpO2, and the tcpCO2. LDF-flux (also LDF-speed and -concentration) showed a slight non significant downward trend with increasing pressure. Th e newly introduced peripheral microcirculatory coefficient pMC, a parameter of microcirculation, estimated using noninvasive NIRP-method exhibited a s ignificant reduction (p less than or equal to 0,001) at compression pressur es already between 0 and 20, continuing to 40 torr in both groups. On the w hole the pMC value in group B was decreased. The spectral number M-L,M-H re flecting vascular tone and estimated from the frequency histogramm of NIRP was unchanged. Conclusion: The absence of reduced ankle pressure, tcpO(2), and the tcpCO(2), respectively demonstrates that in PAOD patients a compres sion pressure of 40 torr does not lead to a significant change in the macro circulation. However, as reflected by the decreased pMC value, the microcir culation is significantly reduced. It is still not clear whether this reduc tion in the microcirculation is a contraindication for compression therapy in PAOD.