Performing Ankle Brachial Index (ABI) Measurement Sensitive and Specific + Inexpensive Test for Diagnosing PAD [In Patients with Clinical History and Exam Suggestive of Chronic Peripheral Arterial Disease] Measuring Resting ABI Accurately: • Patient should be resting >5-10 Minutes • Use Appropriate Cuff Size Place Cuff - 2cm Above (width be at least > 40% circumference of limb) • Place cuff ~2cm above medial malleolus • Recommend CW Doppler to Measure SBP • Inflate Cuff Slowly to ~20 mmHg above loss of flow signal • Slowly Deflate Until Signal Returns (Repeat Measurement in Other Vessel in Same Limb) • Same Sequence Each Time (Right Brachial → Right PT/DP → Left PT/DP → Left Brachial) ABI = Highest Pressure in Lower Limb (DP or PT) / Highest Pressure in Both Arms ABI ≤ 0.9: • In patients with s/sx of PAD, diagnostic (Se of 95%, Sp 100%) for occlusive lesion >50% ABI: 0.91-0.99: • Considered "Borderline" and further diagnostic testing suggested (e.g., Exercise ABI) ABI: 1.0-1.4: • Considered normal. However, if s/sx highly suggestive of PAD, further testing recommended ABI > 1.4: • Indicative of calcified Non-Compressible Vessels. Toe-Brachial Index (TBI) can be used - Karan Desai MD @karanpdesai via CardioNerds @cardionerds #AnkleBrachial #Index #ABI #Measurement #vascular #diagnosis #peripheral #arterial #disease #pad
