Applications

Ankle Brachial Pressure Index (ABPI)

The measurement of Ankle brachial pressure index (ABPI) is a useful non-invasive test to assess vascular status, and in particular to identify the presence of peripheral vascular disease (PVD). Some patients presenting with PVD are asymptomatic, and an abnormal ABPI the first indication of the presence of disease. Calculation of the ABPI is also used in some studies to classify patients with peripheral arterial occlusive disease (Urbančič-Rovan, 2006). ABPI is calculated as the ratio of systolic blood pressure in the lower legs to that in the upper arms (Prompers et al, 2006):

Where PLeg is the systolic blood pressure of dorsalis pedis or posterior tibial arteries and PArm is the highest of the left and right arm brachial systolic blood pressure.

ABPI ratios shown below (TASCII) are of interest in several conditions and clinically important values for ABPI include:

Normal = >0.9
Peripheral vascular disease = 0.9 – 0.5
Critical limb ischaemia = <0.5

Equipment:

The following equipment is recommended for measurement of ABPI:

moorVMS-LDF laser Doppler Monitor
moorVMS-PRES Pressure Cuff Controller
moorVMS-PC dedicated PC software for automated calculations of ABPI and production of Reports
Pressure cuffs

- Arm cuff, also available with ‘quick release’ valve (CUFF - Arm RD)
- Thigh
- Toe/finger

Probes

- VP1T (includes temperature measurement)
- VP1 (not including temperature measurement)

References

Prompers L., Huijberts M., Apelqvist J., Jude E., Piaggesi A., Bakker K et al. 2006 High prevalence of ischaemia, infection and serious comorbidity in patients with diabetic foot disease in Europe. Baseline results from the Eurodiale study. Diabetologia, 50, pp 18-25

Urbančič-Rovan V., Bernjak A., Stefanovska A., Ažman-Juvan K., Kocijančič A. 2006 Macro- and microcirculation in the lower extremities - Possible relationship. Diabetes Research and Clinical Practice, 73, pp 166–173

TASCII Summary of the Inter-Society Consensus for the management of PAD (TASC II) guidelines. Published January 2007, On-line www.tasc2-pad-org. Section A Epidemiology of peripheral artery disease.

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