Ankle brachial index: Difference between revisions

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==Role in health care==
==Role in health care==
===Diagnosis of peripheral arterial disease===
===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/>&bull;&nbsp;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/>&bull;&nbsp;4% had [[peripheral arterial disease]] || ABI by [[palpation]]|| [[Doppler ultrasonography|Doppler]] ABI < 0.9|| 88%|| 82%
|-
| Khan, 2006<ref name="pmid16449619"/><br/>[[Systematic review]]||&nbsp;|| ABI by [[Doppler ultrasonography]] || [[Angiography]]|| 95%|| > 95%
|}


===Prediction vascular disease and mortality===
===Prediction vascular disease and mortality===

Revision as of 12:20, 15 February 2009

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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

Accuracy of the ankle brachial index (ABI) using various methods
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[5][[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)".[6]

References

  1. Anonymous (2024), Ankle brachial index (English). Medical Subject Headings. U.S. National Library of Medicine.
  2. 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. 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. 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.
  5. Cite error: Invalid <ref> tag; no text was provided for refs named pmid18567610/
  6. 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.