Ankle brachial index: Difference between revisions
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The blood pressure at the [[posterior tibial artery]] can be measured by [[Doppler ultrasonography]]<ref name="pmid16449619">{{cite journal |author=Khan NA, Rahim SA, Anand SS, Simel DL, Panju A |title=Does the clinical examination predict lower extremity peripheral arterial disease? |journal=JAMA |volume=295 |issue=5 |pages=536–46 |year=2006 |month=February |pmid=16449619 |doi=10.1001/jama.295.5.536 |url=http://jama.ama-assn.org/cgi/pmidlookup?view=long&pmid=16449619 |issn=}}</ref>, | The blood pressure at the [[posterior tibial artery]] can be measured by [[Doppler ultrasonography]]<ref name="pmid16449619">{{cite journal |author=Khan NA, Rahim SA, Anand SS, Simel DL, Panju A |title=Does the clinical examination predict lower extremity peripheral arterial disease? |journal=JAMA |volume=295 |issue=5 |pages=536–46 |year=2006 |month=February |pmid=16449619 |doi=10.1001/jama.295.5.536 |url=http://jama.ama-assn.org/cgi/pmidlookup?view=long&pmid=16449619 |issn=}}</ref>, | ||
[[palpation]]<ref name="pmid18567610">{{cite journal |author=Migliacci R, Nasorri R, Ricciarini P, Gresele P |title=Ankle-brachial index measured by palpation for the diagnosis of peripheral arterial disease |journal=Fam Pract |volume=25 |issue=4 |pages=228–32 |year=2008 |month=August |pmid=18567610 |doi=10.1093/fampra/cmn035 |url=http://fampra.oxfordjournals.org/cgi/pmidlookup?view=long&pmid=18567610 |issn=}}</ref>, or [[auscultation]].<ref name="pmid19022870">{{cite journal |author=Carmo GA, Mandil A, Nascimento BR, ''et al'' |title=Can we measure the ankle-brachial index using only a stethoscope? A pilot study |journal=Fam Pract |volume=26 |issue=1 |pages=22–6 |year=2009 |month=February |pmid=19022870 |doi=10.1093/fampra/cmn086 |url=http://fampra.oxfordjournals.org/cgi/pmidlookup?view=long&pmid=19022870 |issn=}}</ref> | [[palpation]]<ref name="pmid18567610">{{cite journal |author=Migliacci R, Nasorri R, Ricciarini P, Gresele P |title=Ankle-brachial index measured by palpation for the diagnosis of peripheral arterial disease |journal=Fam Pract |volume=25 |issue=4 |pages=228–32 |year=2008 |month=August |pmid=18567610 |doi=10.1093/fampra/cmn035 |url=http://fampra.oxfordjournals.org/cgi/pmidlookup?view=long&pmid=18567610 |issn=}}</ref>, or [[auscultation]].<ref name="pmid19022870">{{cite journal |author=Carmo GA, Mandil A, Nascimento BR, ''et al'' |title=Can we measure the ankle-brachial index using only a stethoscope? A pilot study |journal=Fam Pract |volume=26 |issue=1 |pages=22–6 |year=2009 |month=February |pmid=19022870 |doi=10.1093/fampra/cmn086 |url=http://fampra.oxfordjournals.org/cgi/pmidlookup?view=long&pmid=19022870 |issn=}}</ref> | ||
==Role in health care== | |||
===Diagnosis of peripheral arterial disease=== | |||
{| class="wikitable" | |||
|+ Accuracy of the ankle brachial index (ABI) using various methods | |||
! rowspan="2"|Study!!rowspan="2"|Patients!!rowspan="2"|Test!!rowspan="2"|Outcome!!colspan="2"|Results | |||
|- | |||
! [[Sensitivity and specificity|Sensitivity]]!! [[Sensitivity and specificity|Specificity]] | |||
|- | |||
|Carmo, 2009<ref name="pmid19022870"/><br/>[[Cross-sectional study]]||81 consecutive patients referred for arterograms of any region. <br/>• 17% had [[peripheral arterial disease]]||ABI by [[auscultation]]||[[Doppler ultrasonography|Doppler]] ABI < 0.9|| 71%|| 91% | |||
|- | |||
|Migliacci, 2008<ref name="pmid18567610"/><br/>[[Cross-sectional study]]||205 patients from 24 [[primary care physician]]s. Subjects has at least one major cardiovascular risk factor.<br/>• 4% had [[peripheral arterial disease]] || ABI by [[palpation]]|| [[Doppler ultrasonography|Doppler]] ABI < 0.9|| 88%|| 82% | |||
|- | |||
| Khan, 2006<ref name="pmid16449619"/><br/>[[Systematic review]]|| || ABI by [[Doppler ultrasonography]] || [[Angiography]]|| 95%|| > 95% | |||
|} | |||
===Prediction vascular disease and mortality=== | |||
A [[meta-analysis]] concluded that "measurement of the [[ankle brachial index|ABI]] may improve the accuracy of cardiovascular risk prediction beyond the FRS (Framingham risk score)".<ref name="pmid18612117">{{cite journal |author=Fowkes FG, Murray GD, Butcher I, ''et al'' |title=Ankle brachial index combined with Framingham Risk Score to predict cardiovascular events and mortality: a meta-analysis |journal=JAMA |volume=300 |issue=2 |pages=197–208 |year=2008 |month=July |pmid=18612117 |doi=10.1001/jama.300.2.197 |url=http://jama.ama-assn.org/cgi/pmidlookup?view=long&pmid=18612117 |issn=}}</ref> | |||
==References== | ==References== | ||
<references/> | <references/> | ||
Latest revision as of 13:21, 15 February 2009
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
| 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
- ↑ Anonymous (2024), Ankle brachial index (English). Medical Subject Headings. U.S. National Library of Medicine.
- ↑ 2.0 2.1 Khan NA, Rahim SA, Anand SS, Simel DL, Panju A (February 2006). "Does the clinical examination predict lower extremity peripheral arterial disease?". JAMA 295 (5): 536–46. DOI:10.1001/jama.295.5.536. PMID 16449619. Research Blogging.
- ↑ 3.0 3.1 Migliacci R, Nasorri R, Ricciarini P, Gresele P (August 2008). "Ankle-brachial index measured by palpation for the diagnosis of peripheral arterial disease". Fam Pract 25 (4): 228–32. DOI:10.1093/fampra/cmn035. PMID 18567610. Research Blogging.
- ↑ 4.0 4.1 Carmo GA, Mandil A, Nascimento BR, et al (February 2009). "Can we measure the ankle-brachial index using only a stethoscope? A pilot study". Fam Pract 26 (1): 22–6. DOI:10.1093/fampra/cmn086. PMID 19022870. Research Blogging.
- ↑ Fowkes FG, Murray GD, Butcher I, et al (July 2008). "Ankle brachial index combined with Framingham Risk Score to predict cardiovascular events and mortality: a meta-analysis". JAMA 300 (2): 197–208. DOI:10.1001/jama.300.2.197. PMID 18612117. Research Blogging.