Artificially high readings of ABPI can be caused by
(A) Arteriosclerosis calcified arteries[?]Theory of ABPI:Ankle-brachial pressure index (ABPI)/Ankle-Brachial index (ABI):Ratio of blood pressure at ankle to blood pressure in upper arm (brachium).Compared to arm, Lower blood pressure in leg suggests blocked arteries due to peripheral artery disease (PAD).Ankle brachial pressure index (ABPI) is a method for the quantification of peripheral vascular disease that results from advanced atherosclerosis.The ABPI is the ratio of the systolic B/P measured at the ankle to that measured at the brachial artery (arm). RATING OF ABPIABI ValueInterpretationRecommendationGreater than 1.4Calcification/Vessel HardeningVascular Intervention1.0-1.4Normal (Resting ABPI)None0.9-1.0Acceptable0.8-0.9Some degree of Arterial obstruction (Claudication)Treat risk factors0.5-0.8Moderate Arterial DiseaseVascular InterventionLess than 0.5Severe Arterial Disease (Rest Pain)Vascular InterventionLess than 0.3Imminent necrosisNeeds Vascular interventionIssues to look out for?Vessels are calcified, limbs are large, fatty, oedematous, cuff too small or limbs Dependant.Inappropriately high readings are obtainedInvestigations:ABPI:Normal value doesn't rule out ischemiaRetest after exercise, ABPI may fall.Post exercise ABPI considered POSITIVE when ABPI fall =0.2 and/or Failure to return to baseline in 3 minutesWrong high readings in calcified arteries, e.g., seen in diabetics & ESRD.Peripheral Vascular Disease:= obstruction of large arteries (not within the coronary, aortic arch or brain vasculature)Main cause is atherosclerosis.Risk Factors:Smoking, diabetes, HTN, sedentary lifestyle, increased cholesterol, obesity.Investigations: Bloods, ABPI, arterial duplex, MR angiographyManagement:Conservative measures - Lose weight, increased exercise, anti-hypertensives, statins, stop smoking.Surgery - Angioplasty, surgical bypass, amputation.
Arteriosclerosis calcified arteries
Ischemic ulcers
Intermittent claudication
Deep Vein Thrombosis
Arterial Disorders