scholarly journals Association between modified ankle-brachial pressure index and indices of adiposity

2021 ◽  
Vol 65 ◽  
pp. 21-27
Author(s):  
Prabhat Ranjan ◽  
Kumar Sarvottam ◽  
Umashree Yadav
Keyword(s):  
Arterial Disease ◽  
Ankle Brachial Pressure Index ◽  
Fat Percentage ◽  
Skin Fold Thickness ◽  
Pressure Index ◽  
Invasive Test ◽  
Significant Difference ◽  
Ankle Pressure ◽  
Healthy Obese ◽  
Overweight Subjects

Objectives: Obesity is one of the important risk factors for peripheral arterial disease (PAD). Ankle-brachial pressure index (ABPI) is a non-invasive test, which may be used for earlier detection of PAD. ABPI in healthy obese/overweight subjects has not been studied. In present study, we investigated correlation of adiposity indices with ABPI. We have also compared ABPI by three different methods in healthy obese/overweight subjects. Materials and Methods: Weight, height, body mass index (BMI), waist circumference, hip circumference (HC), waist height ratio, waist hip ratio, skin fold thickness, and body fat percentage were measured in 45 healthy overweight/obese males. Ankle and brachial pressures were measured by Doppler ultrasound based method. ABPI was calculated using high ankle pressure (ABPI-HIGH), mean ankle pressure (ABPI-MEAN), and low ankle pressure (ABPI-LOW) methods. Results: BMI and HC show positive significant correlation with ABPI-LOW (P = 0.028, P = 0.046, respectively). Significant difference was observed between ABPI-LOW and ABPI-HIGH (P = 0.003). ABPI-MEAN and ABPILOW were also significantly different (P < 0.001). Conclusion: There is a correlation of obesity indices with ABPI-LOW. ABPI-LOW methods could be more appropriate method and contrastingly HC may have direct correlation with PAD detection by ABPI in apparently healthy obese.

Does calculation of ankle brachial pressure index need revision?

VASA ◽  
2005 ◽  
Vol 34 (2) ◽  
pp. 123-126 ◽  
Author(s):  
Diehm ◽  
Kareem ◽  
Diehm ◽  
Jansen ◽  
Lawall
Keyword(s):  
Arterial Disease ◽  
Posterior Tibial Artery ◽  
Arterial System ◽  
Anterior Tibial Artery ◽  
Ankle Brachial Pressure Index ◽  
Pressure Index ◽  
Tibial Artery ◽  
Ankle Pressure ◽  
Peripheral Arterial ◽  
The Right

Peripheral arterial disease (PAD) is a commonly encountered but a commonly under-diagnosed condition in clinical practice. Ankle brachial pressure index (ABI) is a widely used procedure in its detection. It is also a very good prognostic marker not only of PAD but also of mortality. According to the current guidelines ABI of a side i.e. either the left or the right, is the quotient of the higher of the systolic blood pressures (SBP) of the two ankle arteries of that limb (either the anterior tibial artery or the posterior tibial artery) and the higher of the two brachial SBP of upper limbs. With the currently existing method of ABI calculation, considering only the higher of the SBP of the two ankle arteries, a distal stenosis of the ankle arterial system with the lower SBP, may be missed. We suggest a modification to the currently existing of calculating ABI. The method has been termed by us as the low ankle pressure method. In this method the lowest ankle pressure between the two ankle arteries of a particular side is to be the numerator and the denominator could be the same as before. A study or a series of studies comparing our proposed method with the current one are needed to test its clinical utility.

Audible handheld Doppler ultrasound determines reliable and inexpensive exclusion of significant peripheral arterial disease

Vascular ◽  
2015 ◽  
Vol 23 (6) ◽  
pp. 622-629 ◽  
Author(s):  
Afsaneh Alavi ◽  
R Gary Sibbald ◽  
Reza Nabavizadeh ◽  
Farnaz Valaei ◽  
Pat Coutts ◽  
...  
Keyword(s):  
Peripheral Arterial Disease ◽  
Likelihood Ratio ◽  
Doppler Ultrasound ◽  
Predictive Value ◽  
Arterial Disease ◽  
Ankle Brachial Pressure Index ◽  
Diagnostic Reliability ◽  
Pressure Index ◽  
Significant Difference ◽  
Peripheral Arterial

Objective To determine the accuracy of audible arterial foot signals with an audible handheld Doppler ultrasound for identification of significant peripheral arterial disease as a simple, quick, and readily available bedside screening tool. Methods Two hundred consecutive patients referred to an interprofessional wound care clinic underwent audible handheld Doppler ultrasound of both legs. As a control and comparator, a formal bilateral lower leg vascular study including the calculation of Ankle Brachial Pressure Index and toe pressure (TP) was performed at the vascular lab. Diagnostic reliability of audible handheld Doppler ultrasound was calculated versus Ankle Brachial Pressure Index as the gold standard test. Results A sensitivity of 42.8%, a specificity of 97.5%, negative predictive value of 94.10%, positive predictive value of 65.22%, positive likelihood ratio of 17.52, and negative likelihood ratio of 0.59. The univariable logistic regression model had an area under the curve of 0.78. There was a statistically significant difference at the 5% level between univariable and multivariable area under the curves of the dorsalis pedis and posterior tibial models ( p < 0.001). Conclusion Audible handheld Doppler ultrasound proved to be a reliable, simple, rapid, and inexpensive bedside exclusion test of peripheral arterial disease in diabetic and nondiabetic patients.

Ankle Brachial Pressure Index and compression application: Review summary

2019 ◽  
Vol 27 (2) ◽  
pp. 74-77
Author(s):  
Victoria Team ◽  
Georgina Gethin ◽  
John D Ivory ◽  
Kimberley Crawford ◽  
Ayoub Bouguettaya ◽  
...  
Keyword(s):  
Content Analysis ◽  
Clinical Practice ◽  
Venous Insufficiency ◽  
Arterial Disease ◽  
Leg Ulcers ◽  
Current Clinical Practice ◽  
Ankle Brachial Pressure Index ◽  
Arterial Circulation ◽  
Pressure Index ◽  
Peripheral Arterial

Venous leg ulcers (VLUs) are a significant complication amongst persons with chronic venous insufficiency (CVI) that frequently follow a cycle of healing and recurrence. Current clinical practice guidelines (CPGs) recommend applying below knee compression to improve VLU healing. Compression could be applied if the Ankle Brachial Pressure Index (ABPI) rules out significant arterial disease, as sufficient peripheral arterial circulation is necessary to ensure safe compression use. We conducted a content analysis of 13 global CPGs on the accuracy of recommendations related to ABPI and compression application. Eight CPGs indicated that compression is recommended when the ABPI is between 0.8 and 1.2 mmHg. However, this review found there is disagreement between 13 global VLU CPGs, with a lack of clarity on whether or not compression is indicated for patients with ABPIs between 0.6 and 0.8 mmHg. Some CPGs recommend reduced compression for treatment of VLUs, while others do not recommend any type of compression at all. This has implications for when it is safe to apply compression, and the inconsistency in evidence indicates that specialist advice may be required at levels beyond the ABPI “safe” range listed above.

Ankle Brachial Pressure Index: An update for the vascular specialist and general practitioner

Vascular ◽  
2019 ◽  
Vol 27 (5) ◽  
pp. 560-570 ◽  
Author(s):  
Benjamin Thurston ◽  
Joseph Dawson
Keyword(s):  
Blood Pressure ◽  
Peripheral Arterial Disease ◽  
Arterial Disease ◽  
Cardiac Risk Factor ◽  
Diabetic Patients ◽  
Ankle Brachial Pressure Index ◽  
Pressure Index ◽  
Clinical Scenarios ◽  
Invaluable Tool ◽  
Peripheral Arterial

Objectives Ankle brachial pressure index (ABPI) is an invaluable tool for assessing the severity of peripheral arterial disease. In addition, it can be used as an independent marker of cardiovascular risk, with a predictive ability similar to the Framingham criteria. Identification of an abnormal ABPI should therefore trigger aggressive cardiac risk factor modulation for a patient. Unfortunately, the significance of abnormal ABPIs is poorly understood within the general medical community. This is compounded by the influence of various comorbidities on accurate measurement of ABPI, potentially leading to a wide variability in readings that need to be considered before interpretation in these patient populations. We aim to address these issues by revealing several common misunderstandings and pitfalls in ABPI measurement, describing accurate methodology, and highlighting patient cohorts in whom additional or alternative approaches may be required. Methods We present a narrative review of the role of ABPI in both the community and hospital setting. We have performed a literature review, exploring the validity and reproducibility of methodology for obtaining ABPI, alongside the utility of ABPI in different clinical scenarios. Results The measurement of ABPI is often performed incorrectly. Common pitfalls include inadequate patient preparation, failure to obtain the blood pressure from the correct lower limb artery in patients with tibial disease, failure to account for differences in brachial blood pressure between the arms, inappropriately chosen equipment and patient factors such as highly calcified arteries. Standardisation of methodology greatly improves reliability of the test. Exercise ABPI can identify significant peripheral arterial disease in patients with normal resting ABPI. In addition to its role in peripheral arterial disease, ABPI measurement has a role in assessing venous ulcers, entrapment syndromes and injured extremities; conversely, it has a more limited utility in the diabetic population. Conclusions A thorough understanding of the correct technique and associated limitations of ABPI measurement is essential in accurately generating and interpreting the data it provides. With this knowledge, the ABPI is an invaluable tool to help manage patients with peripheral arterial disease. Perhaps more importantly, ABPI can be used to identify and risk stratify patients with asymptomatic peripheral arterial disease, itself a major indicator of significant underlying cardiovascular disease. With the emergence of best medical therapy, targeted pharmacotherapy and lifestyle changes can reduce the risk of major cardiovascular events in high-risk patients by approximately 30%, particularly in diabetic patients. Therefore, the utility of ABPI transgresses vascular surgery, with an essential role in general practice and public health.

scholarly journals DIABETIC FOOT ULCER GRADES

2008 ◽  
Vol 15 (01) ◽  
pp. 133-136
Author(s):  
JOHAR ALI ◽  
ALI AKBAR ◽  
WAQAS ANWAR
Keyword(s):  
Diabetic Foot ◽  
Foot Ulcer ◽  
Diabetic Foot Ulcer ◽  
Arterial Disease ◽  
Ankle Brachial Pressure Index ◽  
Lower Extremity Arterial Disease ◽  
Pressure Index ◽  
Surgical Units ◽  
Study Results ◽  
Grade Ii

Diabetic foot is one of the most common complications of diabetes mellitus. The management and out come is very much dependent on proper assessment of foot ulcer severity. Objectives: To asses severity of diabetic foot and to find a correlation between Ankle Brachial Pressure Index (ABPI) and foot ulcer grades. Study design: Prospective study. Period: Jan 2001 to Dec 2003. Patients & Methods and Setting: Patients with diabetic foot ulcers from all the medical and surgical units of Ayub teaching hospital Abbottabad were enrolled in the study. Results: Ankle Brachial Pressure Index (ABPI) levels revealed 5 (5.8%) with ABPI < 0.5 for grade V, 8 patients (9.3%) ABPI 0.5 – 0.89 for grade IV, 18 patients (20.9%) ABPI 0.9-1 for grade III, 44 (51.2%) ABPI 0.9-1 for grade II, and 9 patients (10.5%) ABPI > 1 for grade I diabetic foot ulcer. This data was analyzed via SPSS version 8.0. Conclusions: Ankle brachial pressure index is a good diagnostic tool to assess the lower extremity arterial disease in diabetic foot patients. ABPI readings should be cautiously interpreted as these may be falsely elevated in atherosclerotic patients.

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