The ankle brachial index also predicts the risk of cardiovascular events, cerebrovascular events, and even death from any cause. Anklebrachial pressure index oxford academic journals. It is the test for the ankle brachial index abi, alternatively called the ankle brachial pressure index abpi. Relationship of ankle brachial index with age, bmi, smoking. How to calculate the ankle brachial index healthy living. The ratio of ankle systolic pressure to brachial artery systolic pressure is termed the anklebrachial pressure index abi and is normally.
Blood pressure in the ankle significantly lower than in the arm is an indication of arterial blockage peripheral arterial disease of blood flow to the legs. Interpretation and significance of anklebrachial systolic. A low ankle brachial index number can indicate narrowing or blockage of the arteries in your legs. The anklebrachial pressure index abpi is a noninvasive method for detecting or rulingout the presence of peripheral artery disease. The ankle brachial systolic pressure index abi is an underutilized, easytoperform, physiologic test to diagnosis atherosclerotic lowerlimb arterial occlusive disease. Using the anklebrachial index to diagnose peripheral. Ensure cuffs are positioned over skin with no clothing under the cuff. The ankle brachial pressure index abpi test is widely used by a diverse range of practitioners in the community and hospital setting in order to screen asymptomatic patients, diagnose patients with clinical symptoms, and to monitor patients who have had radiological or.
Pdf the anklebrachial indexa classification of the. You will lie down on the exam table and blood pressure cuffs will be attached to your arms and legs. The anklebrachial index also predicts the risk of cardiovascular events, cerebrovascular events, and even death from any cause. The test is performed by measuring the blood pressure bp in lower legs and arms and is calculated by dividing the systolic pressure in ankles with systolic pressure in arms. The test can also track the progression of the disease or the effect of treatment. Learn how to do the math in calculating anklebrachial index. Apr 11, 2020 to calculate the ankle brachial pressure index, a doctor or nurse takes the patients blood pressure in his arm, a procedure which many patients may be familiar with, and then repeats the test on the ankle. The anklebrachial pressure index abpi is a noninvasive tool for the assessment of cardiovascular risk cv.
Interpretation of these results is contained in appendix 1. The anklebrachial indexa classification of the patient. The lower value of ankle blood pressure was used for the assessment of abi. Aha releases recommendations on abi measurement and interpretation created date. Quick reference guide for clinicians university of kentucky. This test measures the blood pressure in your legs. Ankle brachial indexabi in adults using a handheld doppler practice level registered nurses must successfully complete additional education and related clinical practice before carrying out ankle brachial index testing.
The anklebrachial index, sometimes called the armankle index, compares blood pressure from two locations. These often occur in people with diabetes or chronic kidney disease. Abpi is a calculation of the ratio of the patients systolic blood pressure at their ankle to the systolic pressure in their arm. Your doctor will put a blood pressure cuff around your ankles as you lie on a table. The ankle brachial pressure index abpi is a noninvasive tool for the assessment of cardiovascular risk cv. The diagnosis pad can be made by means of peripheral pressure measurement and subsequent calculation of the socalled ankle brachial index abi. Abi ankle brachial index abpi ankle brachial pressure index api ankle pressure index in this module, the term abi is used to refer to ankle brachial index. Higher blood pressure in elderly hypertensive females. In such cases, blood pressure should be measured at the toe, where arteries are less likely to be rigid. Racgp peripheral arterial disease screening in general. Knowing the abi is important because it can be used as an indicator of peripheral arterial disease pad. Oct 12, 2009 the ankle brachial pressure index abpi test is widely used by a diverse range of practitioners in the community and hospital setting in order to screen asymptomatic patients, diagnose patients with clinical symptoms, and to monitor patients who have had radiological or surgical intervention. High blood pressure is a major sign of heart disease risk. Anklebrachial index definition of anklebrachial index.
An abpi ankle brachial pressure index is essential to establish arterial perfusion of the lower limb before compression therapy can commence. The ankle brachial index ankle brachial index abi checks the systolic pressure values to diagnose or rule out peripheral arterial disease pad. Abpi compares the brachial systolic pressure and the ankle systolic pressure to gain an indication of arterial perfusion. To improve the use of the ankle brachial index abi measurement, and management of patients with peripheral arterial disease pad a combined training, targeting gps and practice assistants pas. The ankle brachial index test usually lasts about 15 minutes or less. Agency health authority policy and standards should be in place to support this practice.
Should annual measurement of the anklebrachial index be. Calculate an ankle brachial pressure index and toe. The anklebrachial index test is painless and noninvasive, although you might feel slight pressure when the cuffs are inflated. Segmental pressure test, toe pressure test, toebrachial index tbi abiheader. Measurement and interpretation of the anklebrachial index.
To improve the use of the anklebrachial index abi measurement, and management of patients with peripheral arterial disease pad a combined training, targeting gps and practice assistants pas. This method has been found to be both specific 98% and sensitive 90% in detecting stenosis in subsequent studies. Knowing the abi is important because it can be used as an indicator of. Measurement of blood pressure, ankle blood pressure and. The ankle brachial index abi is the ratio of the blood pressure in the lower leg or ankle to the blood pressure in the arm. Originally described by winsor in 1950, this index was initially proposed for the noninvasive diagnosis of lowerextremity peripheral artery disease pad. Pressure index abpi in clinical practice and attempt to. Anklebrachial pressure index abpi measurement osce guide. Few other tests provide as much diagnostic accuracy and. Ankle brachial pressure index abpi is a noninvasive test to measure the arterial blood flow in the lower limbs by using a doppler.
Feb 27, 2016 resting and postexercise ankle brachial index measurements to diagnose asymptomatic peripheral arterial disease in middle aged and elderly chronic obstructive pulmonary disease patients. The ankle brachial index abi is the ratio of the systolic blood pressure at the ankle to the. Anklebrachial pressure index abpi assessment wounds canada. Learn how to do the math in calculating ankle brachial index.
Resting and postexercise anklebrachial index measurements. Anklebrachial pressure index abpi measurement osce. The ankle brachial pressure index is determined by dividing. Feb, 2020 the ankle brachial index test compares the blood pressure measured at your ankle with the blood pressure measured at your arm. If you have a wound or ulcer anywhere on your leg or foot, bring extra dressing supplies to dress the area after. Although there is an association between peripheral arterial disease and cardiovascular death, there are few data to recommend annual measurement of. Leg ulcer management relies on an accurate diagnosis. A portable doppler device is sufficient to perform the measurements. It is expressed as the systolic blood pressure measured at the ankle divided by systolic pressure at the arm. It can also be calculated as a ratio of bloodpressure indices, as measured by a continuouswave doppler ultrasound.
The anklebrachial indexa classification of the patient education websites article pdf available in medical ultrasonography 123. Testing requires a sphygmomanometer and continuouswave doppler probe to measure the ratio of ankle and brachial systolic blood pressures. Peripheral arteries in the body can be affected in the same way as coronary arteries arteries of the heart. The anklebrachial index abi is the ratio of the systolic blood pressure at the ankle to the. Abi was calculated as the ratio of the systolic blood pressure measured at the ankle to that at the brachial artery, with no blood access. The ankle blood pressure is divided by the arm blood pressure to return a value. Anklebrachial index chart ankle pressure mmhg brachial pressure mmhg title. The ankle brachial pressure index abpi or ankle brachial index abi is the ratio of the blood pressure at the ankle to the blood pressure in the upper arm brachium. A total of 315 hypertensive subjects systolic blood pressure 140mmhg were included in this study 155 men and 160 women aged 7188years. Anklebrachial index or abi test society for vascular. Predicting stroke outcomes using anklebrachial index and. Abpi calculator ankle brachial pressure index calculation. The american diabetes association recommends abi screening in anyone over age 50. State the purpose of the abi and explain to patient 2.
It may also be used to stratify patient risk for other cardiac events. Ankle brachial pressure index an overview sciencedirect. Pdf peripheral vascular disease affects some 12%14% of the general population, and the majority of people with the disease are asymptomatic. You may have ankle brachial index testing before and immediately after walking on a treadmill. The distance between the measurement sites in the brachial and ankle was measured with a tape over the surface of the body.
This document was originally developed by the wocn societys clinical practice wound subcommittee as a best practice document for clinicians. Measurements are recorded in millimetres of mmhg to the nearest millimetre. An abnormal reading may be an indication of peripheral artery disease. Instruct individual to remove shoes and socks and long sleeves. The ankle brachial index pdf website accessed on may 29, 2010. Relationship of ankle brachial index with age, bmi. The anklebrachial index abi is a fundamental tool used to assess the risk of peripheral vascular disease. The anklebrachial index test usually lasts about 15 minutes or less. Aha releases recommendations on abi measurement and. Place blood pressure cuffs on both arms and ankles as illustrated, then apply ultrasound gel over brachial, dorsalis pedis, and posterior tibial arteries. Pad prairie initiative ankle brachial index checklist. The clincian should expect the ankle and brachial pressures to be similar, yielding a ratio near 1. Abi was calculated by dividing the higher of the ankle sbp by the higher of the brachial systolic pressure. The anklebrachial index abi is the ratio of the systolic blood pressure sbp measured at the ankle to that measured at the brachial artery.
The aim of this study was to evaluate the risk factors of peripheral arterial disease pad and the relationship between ankle brachial index abi and mortality from allcause and cardiovascular. Position statement on the use of the ankle brachial index in the evaluation of. The anklebrachial index abi is used to screen for peripheral vascular disease. Abstractthe anklebrachial index is valuable for screening for peripheral artery disease in patients at risk and for diagnosing the disease in patients who present with lowerextremity symptoms that suggest it.
Peripheral arterial disease national institute for. People who have symptoms of, or who are at risk of developing, peripheral arterial disease pad are offered a clinical assessment and ankle brachial pressure index abpi measurement. The results of these investigations combined with the clinical assessment of the patient and the limb will help confirm a diagnosis. Ankle brachial pressure index is calculated by dividing the ankle posterior tibial and dorsalis pedis arteries by brachial bloodpressure values as measured by an oscillometer. Ankle brachial index abi, also known as ankle brachial pressure index abpi, is the ratio of the systolic blood pressure in the lower legs to the systolic blood pressure in the arms. This selflearning module will teach you how measure an abi, interpret abi test results and understand the importance of this test for clients. Abstractthe ankle brachial index is valuable for screening for peripheral artery disease in patients at risk and for diagnosing the disease in patients who present with lowerextremity symptoms that suggest it. Resting and postexercise anklebrachial index measurements to diagnose asymptomatic peripheral arterial disease in middle aged and elderly chronic obstructive pulmonary disease patients. Measuring the ankle brachial index abi is an easy and cheap alternative, totally non invasive, that can elegantly be performed during the consultation.
Ankle brachial index definition of ankle brachial index by. It is a ratio composed of the blood pressure in the brachial artery and the pressures in the foot arteries dorsalis pedis and the posterior tibial artery. Using a doppler ultrasound device to measure blood pressure bp in a patients arms and ankles provides the data you need to calculate abi. The ankle brachial index test compares the blood pressure measured at your ankle with the blood pressure measured at your arm. The ankle brachial index also offers information about general cardiovascular health. Ankle brachial index an overview sciencedirect topics. Mr dimitri aerden, the first author, conducting a vascular assessment to determine an anklebrachial pressure index. The anklebrachial pressure index bpj 60 april 2014. Databases searched included pubmed, cochrane, embase, scopus, web of science and informit health collection. Anklebrachial index definition of anklebrachial index by. The anklebrachial index test is a quick, noninvasive way to check for peripheral artery disease pad.
Diagnostic criteria for the anklebrachial index were standardized in 2011 table 1. Diagnostic criteria for the ankle brachial index were standardized in 2011 table 1. The ankle brachial index test is painless and noninvasive, although you might feel slight pressure when the cuffs are inflated. To calculate the ankle brachial pressure index, a doctor or nurse takes the patients blood pressure in his arm, a procedure which many patients may be familiar with, and then repeats the test on the ankle. The ankle brachial index abi is a fundamental tool used to assess the risk of peripheral vascular disease. The anklebrachial pressure index abpi is a noninvasive method of assessing the extent of chronic peripheral arterial disease in the lower limbs. Ankle brachial index definition of ankle brachial index.
Jul 11, 2019 the ankle brachial index abi is the ratio of the blood pressure in the lower leg or ankle to the blood pressure in the arm. It is the test for the anklebrachial index abi, alternatively called the anklebrachial pressure index abpi. To find out your anklebrachial index, a technician measures the blood pressure in your ankle and your arm. The anklebrachial index can help your doctor check for peripheral artery disease pad. Wear clothing that will allow access to your thigh, calf, ankle and foot. Anklebrachial index ohio state conditions and treatments. While it is by no means definitive, there is a simple test procedure that offers a clue to the viability of the endothelium as it relates to ed. Using the anklebrachial index to diagnose peripheral artery. Our aim was to determine the prevalence of an abnormal abpi in patients with sv and healthy controls and to correlate with clinical and serological parameters. Aortic pulse wave velocity and augmentation index were determined using sphygmocor, and brachial blood pressure was measured using an oscillometric technique. First, the person lies down for about 10 minutes to equalize the effect of gravity on blood pressure in the arms and legs. Journal of clinical medicine article predicting stroke outcomes using ankle brachial index and inter ankle blood pressure di erence minho han 1, young dae kim 1,2, jin kyo choi 1, junghye choi 1, jimin ha 1, eunjeong park 3, jinkwon kim 4, taejin song 5, ji hoe heo 1,2 and hyo suk nam 1,2, 1 department of neurology, yonsei university college of medicine, seoul 03722, korea. Compared to the arm, lower blood pressure in the leg suggests blocked arteries due to peripheral artery disease pad. An ankle brachial index test, also known as an abi test, is a procedure that can test the blood pressure in your extremities.
The anklebrachial systolic pressure index abi is an underutilized, easytoperform, physiologic test to diagnosis atherosclerotic lowerlimb arterial occlusive disease. The american heart association estimates that over 8 million americans have vascular disease, which can lead to an increased incidence of heart attack, stroke, aneurysms and chronic venous disease. A large difference between the two can signal the presence of peripheral artery disease. Measuring the ankle brachial indexabi is an easy and cheap alternative, totally non invasive, that can elegantly be performed during the consultation. The ankle brachial index is used to estimate if a person is subjected to the peripheral artery disease pad.