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The ankle-brachial index is a noninvasive examination that provides baseline data regarding circulation in the lower limbs and provides the basis for a diagnosis of peripheral artery disease (PAD). It can be performed in conjunction with ultrasound for better results. A blood pressure cuff is put around the ankle above the malleolus. When the dorsalis pedis pulse has been located via a Doppler, the cuff is inflated in the usual manner until the Doppler signal is no longer heard. As the cuff is slowly deflated, the systolic pressure is recorded when the signal returns. The same procedure is done by using a Doppler on the posterior tibial pulse. The higher pressure of the two pressures is used for the calculation of the index. The brachial systolic pressure is then measured in the same manner and is divided into the ankle systolic pressure. The lower of the two numbers (right vs. left) results in the overall ABI.

Figure 2.7