Vigilance, Jacqueline E; Reid, Harvey L.; Richards-George, P.; Mills, James L.
Author Affiliation, Ana.
Department of Basic Medical Sciences
Comparison of doppler-sphygmomanometer and venous occlusion air-plethysmography in the diagnosis of peripheral occlusive arterial disease
Journal of Vascular Technology
Date of Publication
The aim of this study was to determine whether ankle-brachial systolic pressure index (TBI) and toe-brachial systolic pressure index (TBI) derived from the VascuMAP AP-102 V (an air plethysmograph) blood pressure measurements were as reliable in the detection of Peripheral Occlusive Arterial Disease (POAD) as the traditional Doppler method used in the diagnosis of POAD. Ankle and brachial systolic pressures were measured in a group of 80 diabetic patients and 22 nondiabetic subjects without a history of peripheral vascular disease. Both groups were comparable in age and sex. The VascuMAP AP-102V, was used to measure blood pressure in both arms, both ankles and both great toes. A sphygmomanometer in conjunction with a hand-held doppler device, the Multidopplex MD1, were also used to measure arm and ankle systolic blood pressures. The ABI and TBI derived from VascuMAP systolic blood pressure measurements were compared with the ABI obtained from Doppler sphygmomanometry. POAD was defined by the absence of peripheral pulses, namely, the dorsalis pedis or posterior tibialis, and/or an ABI <0.9. Reactive hyperaemia was performed at the ankle and systolic pressures before and after reactive hyperaemia were compared. Twenty-six percent of diabetics were diagnosed by Doppler sphygmomanometry as having POAD in one or both legs, compared with 6% detected by the resting ABI derived from VascuMAP pressure measurements (ABI-V). There was no significant correlation between the Doppler-derived ABI and the ABI-V. Ankle systolic pressure after reactive hyperaemia did not identify diabetic patients with POAD, previously undiagnosed by resting ABI-V. A comparison of the TBI and the Doppler ABI ratios showed that although the ratios were not similar, both gave an indication of which subjects had POAD. Resting ABI-V was 100% specific and 27.7% sensitive, while the TBI was 61.5% sensitive and 91.25% specific compared with the ABI from Doppler sphygmomanometry. The results suggest that the TBI, rather than the resting ABI, is more likely to give an accurate diagnosis of POAD when the VascuMAP is used to measure limb pressures.....