Measurement of Ankle Pressure and Abi

A 66-year-old male had intermittent claudication. His ankle pressures were measured with a doppler stethoscope Clinical Examination in the Diagnosis of Peripheral Artery Disease of the Lower Extremity. Arteria dorsalis pedis is located by moving the probe slowly over the dorsum of the foot until the arterial sound is heard. The cuff pressure is increased rapidly at first until the sound becomes weaker, and then very slowly until the sound disappears. When the pressure is slowly lowered, the sound becomes audible again. The latter pressure reading is the most exact measure of the systolic pressure. However, if the sound is very weak, the reappearance of the sound may be difficult to hear - in such cases the point where the sound disappears when the pressure is increased should be recorded as the systolic pressure. In this patient the arterial sound is strong, but the low pitch, smoothness, and monophasic nature of the sound suggest arterial obstruction (the sound of a healthy artery is biphasic) - an amplified audio sample is heard a the end of the video. The systolic ankle pressure was 164, while the brachial systolic pressure was 190. The systolic pressure from A. tibialis posterior was 150. The ankle-brachial index (ABI) = 164/190 = 0.84. The patient has peripheral artery occlusive disease. The treatment was at this phase conservative Lower Limb Ischaemia. Note: this video has a sound track. If no sound is audible, turn on the audio of your computer.

Measurement of Ankle Pressure and Abi