Intramuscular pressure changes during and after revascularization of the femoral arteries in humans.

Abstract

AbstractIntramuscular pressures in the anterior tibial compartments of the lower extremity were measured by the wick catheter technique in 5 patients undergoing revascularization of the femoral arteries by bifurcation grafting, because of occlusive arteriosclerotic disease. The intramuscular pressure at rest was within a normal range preoperatively (9.1±4.5 mm Hg), but rose significantly to a maximum level 4–6 hours after blood flow was reestablished (22.4±5.0 mm Hg), followed by a gradual decrease over 5 postoperative days, and reached the preoperative value on the 5th postoperative day (8.7±5.1 mm Hg). Changes in calf circumferences reflect the changes in intramuscular pressure. No significant changes in intramuscular pressures were seen when measured at different times during the day. Addition of thoracic epidural anesthesia did not affect the intramuscular pressures as compared to a combination of balanced anesthesia alone.During occlusion of the aorta (clamping), no changes in intramuscular pressures were seen, but the pressure rose significantly immediately after declamping. The intramuscular pressures in the anterior tibial compartment correspond well with the findings on metabolic events seen after declamping, suggesting an incomplete ischemia of the leg muscles with insufficient tissue perfusion.