Utility of Toe-brachial Index for Diagnosis of Peripheral Artery Disease
Open Access
- 1 May 2012
- journal article
- Published by Georg Thieme Verlag KG in Archives of Plastic Surgery
- Vol. 39 (03), 227-231
- https://doi.org/10.5999/aps.2012.39.3.227
Abstract
Background The ankle brachial pressure index (ABI) is a simple, useful method for diagnosing peripheral artery disease (PAD). Although the ABI is an objective diagnostic method, it has limited reliability in certain scenarios. The aim of the present study was to determine the accuracy and reliability of the toe brachial index (TBI) as a diagnostic tool for detecting stenosis in PAD, associated with normal or low ABI values. Methods ABI and TBI values were measured in 15 patients with diabetic gangrene who were suspected of having lower extremity arterial insufficiency. The ABI and TBI values were measured using a device that allowed the simultaneous measurement of systolic blood pressure in the upper and lower extremities. In addition, the ABI and TBI values were compared pre- and post-angiography. Results Patients with an ABI of 0.9-1.3 showed almost no difference between the 2 measurements. The patients with TBI >0.6 had no arterial insufficiency. The patients with TBI <0.6 required vascular intervention with ballooning. After the angiography, the gangrenous wounds decreased in size more rapidly than they did prior to the intervention. Conclusions Our findings suggest that TBI is the method of choice for evaluating lower limb perfusion disorders. This result requires further studies of TBI in a larger number of patients. Future long-term studies should therefore evaluate the utility of TBI as a means of screening for PAD and the present findings should be regarded as preliminary outcomes.Keywords
This publication has 6 references indexed in Scilit:
- Preliminary assessment of an automatic screening device for peripheral arterial disease using ankle–brachial and toe–brachial indicesBlood Pressure Monitoring, 2011
- Prevalence and Risk Factors of PAD among Patients with Elevated ABIEuropean Journal of Vascular and Endovascular Surgery, 2008
- Arteriopatía periférica en el paciente diabético: utilidad del índice dedo-brazoMedicina Clinica, 2008
- High prevalence of peripheral arterial disease and co-morbidity in 6880 primary care patients: cross-sectional studyAtherosclerosis, 2004
- Peripheral Arterial Disease Detection, Awareness, and Treatment in Primary CareJama-Journal Of The American Medical Association, 2001