[Pulse oximetry for the assessment of lower extremity ischemia]. / Pulsoximetri til bedømmelse af underekstremitetsiskaemi.

The purpose of this study was to compare pulse oximetry with ankle and toe pressure measurements in a group of 25 patients with lower limb ischaemia. Measurements were performed on 49 limbs. Pulse oximetry recordings from the second toe were obtainable in only 28 (57%) cases. With lower ankle or toe pressure and more severe symptoms, oximetry was less likely to be possible. In all cases of successful recordings, the oxygen saturation at second toe level was identical with the finger saturation. These data indicate that pulse oximetry has no value in the assessment of peripheral arterial occlusive disease.

Vascular complications following therapeutic and diagnostic cardiac catheterisation by the femoral artery.

Twenty-one of 6327 (0.33%) patients undergoing cardiac catheterisation via the femoral artery had an acute vascular complication requiring surgical intervention. The complication rate was 0.1% after coronary angiography, 2% after PTCA and 6% after aortic ballon dilatation. The size of the catheter and the duration of catheterisation were found to be risk factors. Most commonly simple arterial repair and/or thrombectomy was performed. No mortality was observed. Only in one case was blood transfusion necessary. The outcome of surgery was in all cases a good revascularisation of the leg. Registration and evaluation of vascular injuries following diagnostic and therapeutic invasive interventions could have a self limitating effect on the complication rate.

Can colonoscopy diagnose transmural ischaemic colitis after abdominal aortic surgery? An evidence-based approach.

OBJECTIVES: to assess the diagnostic value of colonoscopy in ischaemic colitis following abdominal aortic surgery, based on a literature review, and to introduce the concept of evidence-based medicine. METHOD: a review of the literature according to evidence-based principles was made by all doctors of our department. RESULTS: seven prospective non-randomised reports on routine colonoscopy after abdominal aortic surgery were found. None of the participants found all the reports, and the last was identified by the reviewer. CONCLUSIONS: Endoscopy may disclose ischaemic colitis, but cannot separate transmural from the clinically less important mucosal ischaemia. Endoscopy had no impact on mortality in any of the prospective series. The evidence-based conference was an inspiring teaching modality, and illustrated for the participants the difficulty in performing a targeted literature search.