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

Background. The aim of this study was to evaluate the usefulness of the pie zoelectric pulse sensor device (Pulse Chek(TM)) 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 gr oups with peripheral arterial occlusive disease were included; a surgical g roup undergoing femoropopliteal bypass grafting (22 patients) and a group u ndergoing PTA of the femoral or popliteal arteries (18 patients). Measures: the piezoelectric pulse sensor was applied on the skin over the dorsalis p edis artery. A baseline waveform was recorded preoperatively and continuous monitoring begun immediately after the surgical or interventional procedur e. Hard copy recordings of the pulse wave were done in the immediate postop erative 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 accurat ely 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 (7 8%) PTA group patients, postoperative monitoring was reliable, the pulse wa veform confirmed patency of the vessel. Piezoelectric pulse sensor device m onitoring did not detect graft occlusion in only one patient in the surgica l group where interpretation of the pulse wave was complicated by a slow at rial fibrillation. There were 19 alarms in the pulse waveform during monito ring for 11 (55%) surgical group patients and 18 alarms for 9 (64%) PTA gro up patients. None of the alarms resulted from graft occlusion. Reliable pul se 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 pati ents in the follow-up assessment after the mean 34 days. One surgical patie nt was lost to follow-up. Conclusions. The piezoelectric pulse sensor device can be recommended as a method of continuous monitoring immediately after the revascularization pro cedure in those patients who have a pedal artery where a reliable pulse wav eform can be recorded.