Ankle-Brachial Index: Difference between revisions

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The ankle-brachial index ABI is measured by dividing the ankle systolic pressure by brachial systolic pressure.
The ankle-brachial index ABI is measured by dividing the ankle systolic pressure by brachial systolic pressure.


== How to measure ==
== Procedures ==
 
=== Tools ===
Hand-held Doppler, or hand-held ultrasound device that's pressed on your skin
 
Inflated cuff
 
=== Preparation ===
Rest for minutes before the measurements 10-30 minutes like normal blood pressure taken during normal visits.
 
Loose, comfortable clothes will be a better choice for easily wearing the inflated cuff on the upper arm. 
 
Avoid nicotine/ smoking as it shows an increase in the peripheral systolic pressure resulting in elevated ABI value<ref>Aboyans V, Criqui MH, Abraham P, Allison MA, Creager MA, Diehm C, Fowkes FG, Hiatt WR, Jönsson B, Lacroix P, Marin B. [https://www.ahajournals.org/doi/full/10.1161/cir.0b013e318276fbcb Measurement and interpretation of the ankle-brachial index: a scientific statement from the American Heart Association. Circulation]. 2012 Dec 11;126(24):2890-909.</ref>.
 
Supported, comfortable position, and avoid limb movement during measurements.
 
The supine position is the position of choice as the sitting position shows about 0.3 increase in the ABI<ref>Xu Y, Xu W, Wang A, Meng H, Wang Y, Liu S, Li R, Lu S, Peng J. [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6504268/ Diagnosis and treatment of traumatic vascular injury of limbs in military and emergency medicine: A systematic review]. Medicine. 2019 May;98(18).</ref>,
 
=== Technique ===
The same procedures as in the measurement of normal blood pressure, with the patient in rested position, it is better to measure the brachial pressure before the ankle pressure:
 
1- Place the cuff around the patient's arm, use the hand-held ultrasound device or hand doppler and press against the skin at the level of the brachial artery in the arm in order to hear the waves of the systolic pressure, and record the measurement.
 
2- Place the cuff around the lower leg and use the  hand-held ultrasound device to hear the waves of the systolic pressure at two levels :
* [[Dorsalis Pedis Artery|Dorsalis pedis]], which is a branch from the [[Tibial Nerve|anterior tibial artery]], it is located between the [[Tibialis Anterior|tibialis anterior]] and [[Extensor Hallucis Longus|extensor hallucis longus]]
* Posterior tibial pulse, that is behind the lateral malleoli.
3- Record the highest pulse between two measurements of dorsalis pedis and posterior tibial arteries.
 
4- The ankle-brachial index calculated by dividing the highest value of ankle systolic pressure between the two arteries by the the highest brachial pressure between two sides.
 
Repeat the ankle measuremet


== Sub Heading 3 ==
== Sub Heading 3 ==


== Resources  ==
== Resources  ==
*bulleted list
[https://www.mayoclinic.org/tests-procedures/ankle-brachial-index/about/pac-20392934 Mayo Clinic, Ankle- Brachial Index]
*x
or


#numbered list
[https://www.health.harvard.edu/newsletter_article/ankle-brachial-index Harvard Health, ABI]
#x


== References  ==
== References  ==

Revision as of 23:52, 17 September 2020

Original Editor - User Name

Top Contributors - Khloud Shreif, Chloe Waller, Lucinda hampton and Vidya Acharya  

This article or area is currently under construction and may only be partially complete. Please come back soon to see the finished work! (17/09/2020)

Introduction[edit | edit source]

The ankle-brachial index, ankle-arm index, ankle-arm ratio, or the Winsor Index, it was first described in 1950 by Winsor. ABI is a quick noninvasive technique used to check the peripheral arterial disease PAD, it assesses the severity of arterial insufficiency of arterial narrowing during walking. PAD is the reduction in the arterial blood flow to the limbs during walking causing pain and may predispose to heart attack and stroke, it affects 10%  of populations who are above 55 years.

The ankle-brachial index ABI is measured by dividing the ankle systolic pressure by brachial systolic pressure.

Procedures[edit | edit source]

Tools[edit | edit source]

Hand-held Doppler, or hand-held ultrasound device that's pressed on your skin

Inflated cuff

Preparation[edit | edit source]

Rest for minutes before the measurements 10-30 minutes like normal blood pressure taken during normal visits.

Loose, comfortable clothes will be a better choice for easily wearing the inflated cuff on the upper arm. 

Avoid nicotine/ smoking as it shows an increase in the peripheral systolic pressure resulting in elevated ABI value[1].

Supported, comfortable position, and avoid limb movement during measurements.

The supine position is the position of choice as the sitting position shows about 0.3 increase in the ABI[2],

Technique[edit | edit source]

The same procedures as in the measurement of normal blood pressure, with the patient in rested position, it is better to measure the brachial pressure before the ankle pressure:

1- Place the cuff around the patient's arm, use the hand-held ultrasound device or hand doppler and press against the skin at the level of the brachial artery in the arm in order to hear the waves of the systolic pressure, and record the measurement.

2- Place the cuff around the lower leg and use the hand-held ultrasound device to hear the waves of the systolic pressure at two levels :

3- Record the highest pulse between two measurements of dorsalis pedis and posterior tibial arteries.

4- The ankle-brachial index calculated by dividing the highest value of ankle systolic pressure between the two arteries by the the highest brachial pressure between two sides.

Repeat the ankle measuremet

Sub Heading 3[edit | edit source]

Resources[edit | edit source]

Mayo Clinic, Ankle- Brachial Index

Harvard Health, ABI

References[edit | edit source]

  1. Aboyans V, Criqui MH, Abraham P, Allison MA, Creager MA, Diehm C, Fowkes FG, Hiatt WR, Jönsson B, Lacroix P, Marin B. Measurement and interpretation of the ankle-brachial index: a scientific statement from the American Heart Association. Circulation. 2012 Dec 11;126(24):2890-909.
  2. Xu Y, Xu W, Wang A, Meng H, Wang Y, Liu S, Li R, Lu S, Peng J. Diagnosis and treatment of traumatic vascular injury of limbs in military and emergency medicine: A systematic review. Medicine. 2019 May;98(18).

This article or area is currently under construction and may only be partially complete. Please come back soon to see the finished work! (17/09/2020)