Ankle brachial index

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In medicine and the physical examination, the ankle brachial index is the "comparison of the blood pressure between the brachial artery and the posterior tibial artery. it is a predictor of peripheral arterial disease."[1]

Method

The blood pressure at the posterior tibial artery can be measured by Doppler ultrasonography[2], palpation[3], or auscultation.[4]

Role in health care

Diagnosis of peripheral arterial disease

Accuracy of the ankle brachial index (ABI) using various methods
Study Patients Test Outcome Results
Sensitivity Specificity
Carmo, 2009[4]
Cross-sectional study
81 consecutive patients referred for arterograms of any region.
• 17% had peripheral arterial disease
ABI by auscultation Doppler ABI < 0.9 71% 91%
Migliacci, 2008[3]
Cross-sectional study
205 patients from 24 primary care physicians. Subjects has at least one major cardiovascular risk factor.
• 4% had peripheral arterial disease
ABI by palpation Doppler ABI < 0.9 88% 82%
Khan, 2006[2]
Systematic review
  ABI by Doppler ultrasonography Angiography 95% > 95%

Prediction vascular disease and mortality

A meta-analysis concluded that "measurement of the ABI may improve the accuracy of cardiovascular risk prediction beyond the FRS (Framingham risk score)".[5]

References