#PAGE_PARAMS# #ADS_HEAD_SCRIPTS# #MICRODATA#

The ankle-brachial index in diabetes - what is the most appropriate measurement method?


Authors: Homza M. 1,2;  Machaczka O. 3;  Porzer M. 1,2;  Kozák M. 4;  Plášek J. 1,2;  Šipula D. 1,2
Authors place of work: Kardiovaskulární oddělení, FN Ostrava 2 Katedra interních oborů, LF OU, Ostrava 3 Ústav epidemiologie a ochrany veřejného zdraví, LF OU, Ostrava 4 Interní kardiologická klinika LF MU a FN Brno 1
Published in the journal: Kardiol Rev Int Med 2018, 20(4): 300-303

Summary

The ankle-brachial index (ABI) is a principal screening tool for the detection of lower extremity arterial disease. In our study with 40 diabetic patients, we evaluated the ability of different ABI methods to detect significant (>50%) stenosis in the lower extremity arteries determined by duplex ultrasonography. According to our results, the ABI obtained through the calculation utilising the lowest of the arterial pressures measured by the Doppler ultrasound at the ankle level (LAP) performed significantly better in this respect than either oscillometric ABI or even the guideline-recommended method that uses the higher of the ankle arterial pressures. For this reason, we believe it would be more appropriate to use the LAP method for screening in diabetic patients. At the same time, Doppler ABI measurement is missing in the Czech Healthcare Procedure Directory. We believe that this procedure should be added to the directory, at least for diabetic patients.

Key words:

ankle-brachial index – ABI – screening – lower extremity arterial disease – Doppler – Czech Healthcare Procedure Directory


Zdroje

1. Aboyans V, Ricco JB, Bartelink ME et al. 2017 ESC Guidelines on the dia­gnosis and treatment of peripheral arterial dis­eases, in col­laboration with the European Society for Vascular Surgery (ESVS). Eur Heart J 2018; 39(9): 763–816. doi: 10.1093/eurheartj/ehx095.

2. Rooke TW, Hirsch AT, Misra S et al. 2011 ACCF/AHA focused update of the guideline for the management of patients with peripheral artery dis­ease (updat­­ing the 2005 Guideline): a report of the American Col­lege of Cardiology Foundation/American Heart As­sociation Task Force on practice guide­lines. Circulation 2011; 124(18): 2020–2045. doi: 10.1161/CIR.0b013e31822e80c3.

3. Gerhard-Herman MD, Gornik HL, Bar­rett C et al. 2016 AHA/ACC Guideline on the management of patients with lower extremity peripheral artery dis­ease: executive sum­mary: a report of the American Col­lege of Cardiology/American Heart As­sociation task force on clinical practice guide­lines. J Am Coll Cardiol 2017; 69(11): 1465–1508. doi: 10.1016/j.jacc.2016.11.008.

4. American Diabetes As­sociation. Peripheral arterial dis­ease in people with diabetes. Diabetes Care 2003; 26(12): 3333–3341.

5. Mas­smann A, Stemler J, Fries P et al. Automated oscil­lometric blood pres­sure and pulse-wave acquisition for evaluation of vascular stif­fness in atherosclerosis. Clin Res Cardiol 2017; 106(7): 514–524. doi: 10.1007/s00392-017-1080-7.

6. Špan M, Geršak G, Mil­las­seau SC et al. Detection of peripheral arterial dis­ease with an improved automated device: comparison of a new oscil­lometric device and the standard Doppler method. Vasc Health Risk Manag 2016; 12: 305–311. doi: 10.2147/VHRM.S106534.

7. Benchimol A, Bernard V, Pil­lois X et al. Validation of a new method of detect­­ing peripheral artery dis­ease by determination of ankle-brachial index us­­ing an automatic blood pres­sure device. Angiology 2004; 55(2): 127–134. doi: 10.1177/000331970405500203.

8. Beckman JA, Higgins CO, Gerhard-Herman M. Automated oscil­lometric determination of the ankle-brachial index provides accuracy neces­sary for of­fice practice. Hypertension 2006; 47(1): 35–38. doi: 10.1161/01.HYP.0000196686.85286.9c.

9. Nukumizu Y, Matsushita M, Sakurai T et al. Comparison of Doppler and oscil­lometric ankle blood pres­sure measurement in patients with angiographical­­ly documented lower extremity arterial occlusive dis­ease. Angiology 2007; 58(3): 303–308.

10. Aboyans V, Lacroix P, Doucet S et al. Dia­gnosis of peripheral arterial dis­ease in general practice: can the ankle-brachial index be measured either by pulse palpation or an automatic blood pres­sure device? Int J Clin Pract 2008; 62(7): 1001–1007. doi: 10.1111/j.1742-1241.2008.01784.x.

11. Wohlfahrt P, Ingrischová M, Krajcoviechová Aet al. A novel oscil­lometric device for peripheral arterial dis­ease screen­­ing in everyday practice. The Czech-post MONICA study. Int Angiol 2011; 30(3): 256–261.

12. Takahashi I, Furukawa K, Ohishi W et al. Comparison between oscil­lometric- and Doppler-ABI in elderly individuals. Vasc Health Risk Manag 2013; 9: 89–94. doi: 10.2147/VHRM.S39785.

13. Aerden D, Mas­saad D, von Kemp K et al. The ankle-brachial index and the diabetic foot: a troublesome mar­riage. Ann Vasc Surg 2011; 25(6): 770–777. doi: 10.1016/j.avsg.2010.12.025.

14. Espinola-Klein C, Rupprecht HJ, Bickel C et al. Dif­ferent calculations of ankle-brachial index and their impact on cardiovascular risk prediction. Circulation 2008; 118(9): 961–967. doi: 10.1161/CIRCULATIONAHA.107.763227.

15. Schröder F, Diehm N, Kareem S et al. A modified calculation of ankle-brachial pres­sure index is far more sensitive in the detection of peripheral arterial dis­ease. J Vasc Surg 2006; 44(3): 531–536. doi: 10.1016/j.jvs.2006.05.016

16. Seznam zdravotních výkonů. Ministerstvo zdravotnictví ČR. Available at: https://szv.mzcr.cz.

17. Aboyans V, Criqui MH, Abraham P et al. Measurement and interpretation of the ankle-brachial index: a scientific statement from the American Heart As­sociation. Circulation 2012; 126(24): 2890–2909. doi: 10.1161/CIR.0b013e318276fbcb.

18. Aboyans V, Ho E, Denenberg JO et al. The as­sociation between elevated ankle systolic pres­sures and peripheral occlusive arterial dis­ease in diabetic and nondiabetic subjects. J Vasc Surg 2008; 48(5): 1197–1203. doi: 10.1016/j.jvs.2008.06.005.

Štítky
Paediatric cardiology Internal medicine Cardiac surgery Cardiology
Prihlásenie
Zabudnuté heslo

Zadajte e-mailovú adresu, s ktorou ste vytvárali účet. Budú Vám na ňu zasielané informácie k nastaveniu nového hesla.

Prihlásenie

Nemáte účet?  Registrujte sa

#ADS_BOTTOM_SCRIPTS#