Assessment of the Ankle Systolic Pressure Index in Patients Over 70 Years of Age With Jaundice Ulcer

  • STATUS
    Recruiting
  • End date
    Jun 1, 2022
  • participants needed
    80
  • sponsor
    Groupe Hospitalier Paris Saint Joseph
Updated on 23 March 2021

Summary

Arteriopathy of the lower limbs (ALL) is defined by a decreased ankle perfusion pressure with a systolic pressure index (SPI) <0.9, and constitutes the most advanced situation in terms of cardiovascular prognosis with in 20 % of cases of lesions associated with the heart and / or coronary heart. The severity of ALL is linked to the risk of a cardiovascular event, hence the need for a hemodynamic evaluation which is mainly based on the measurement of SPI.

Description

However, the presence of mediacalcosis, making the arteries incompressible, limits the interpretation of IPS. However, ALL affects 50% of diabetic patients after 20 years of disease with predominant involvement in the infra-popliteal gland consisting mainly of mediacalcosis, but often respecting the arteries of the foot.

The recommendations of the French-speaking Association for the Study of Diabetes and Metabolic Diseases in 1997 and of the American Diabetes Association in 2001, recommended the SPI and the realization of ultrasound for the diagnosis of ALL. Some authors have shown that SPI can be falsely normal with 4.3 times more false negative ankle SPI in diabetics compared to the general population. This is why this measurement of the SPI is coupled with the measurement of the pressure of the big toe (PGT) or even the transcutaneous measurement of the oxygen pressure (TcPO2) as recommended by the American Heart Association (AHA) and the American College of Cardiology (ACC) in 2005, in case of uninterpretable IPS.

The subjects at risk of mediacalcosis are: diabetics, renal insufficiency and the very elderly.

A recent thesis work confirmed that the SPI alone was not reliable as a screening tool in diabetic patients, with good sensitivity of the measurement of PGT.

What about a population over the age of 70, without diabetes and without kidney failure?

Details
Condition Arterial Disease, Artery Disease, Arteriopathy, artery diseases
Clinical Study IdentifierNCT04794192
SponsorGroupe Hospitalier Paris Saint Joseph
Last Modified on23 March 2021

Eligibility

Yes No Not Sure

Inclusion Criteria

Man or woman aged> 70 hospitalized in the vascular medicine department of the Paris Saint-Joseph Hospital Group
French-speaking patient

Exclusion Criteria

Patient with treated or untreated diabetes
Renal failure (GFR CKD-EPI or MDRD <60ml / min)
ATCD revascularization or amputation
Patient under guardianship or curatorship
Patient deprived of liberty
Patient objecting to participation in the study
Patient under legal protection
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