Ankle-Brachial index

ABI. Adapted from TCT 2005

Ankle-Brachial Index

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• Ankle and brachial systolic pressures taken using a hand-held Doppler instrument
• Supine, after ~10 minutes rest
• The resting ABI should be used to stablish the lower extremity PAD diagnosis in patients with suspected lower extremity PAD
  • Exertional leg symptoms
  • Non healing wounds
  • 70 years and older or 50 years and older with history of smoking or diabetes
• ABI should be measured in both legs in all new patients with PAD of any severity to confirm the diagnosis and establish a baseline
• The toe-brachial index should be used to establish the lower extremity PAD diagnosis in patients in whom lower extremity PAD is clinically suspected but in whom the ABI test is not reliable due to noncompressible vessels (advance age or diabetes)
• Leg segmental pressure measurements are useful to establish the lower extremity PAD diagnosis when anatomic localization of lower extremity PAD is required to create a therapeutic plan.

Additional Reading

• Moss and Adams' Heart Disease in Infants, Children, and Adolescents Hugh D. Allen, Arthur J. Moss, David J. Driscoll, Forrest H. Adams, Timothy F. Feltes, Robert E. Shaddy, 2007 ISBN 0781786843
• Hurst's the Heart, Fuster V, 12th ed. 2008, ISBN 978-0-07-149928-6
• Willerson JT, Cardiovascular Medicine, 3rd ed., 2007, ISBN 978-1-84628-188-4