Ankle-Brachial Index
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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, repeat on the other arm and record the highest 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, which is a branch from the anterior tibial artery, it is located between the tibialis anterior and 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 highest brachial pressure between two sides.
5- Repeat the ankle measurement for the other leg in order to calculate its ABI.
6- The normal ABI is between 0.90 and 1.30, below indicate PAD, above may be a sign of arterial calcification.
Sub Heading 3[edit | edit source]
Resources[edit | edit source]
Mayo Clinic, Ankle- Brachial Index
References[edit | edit source]
- ↑ 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.
- ↑ 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! (18/09/2020)
