Evaluation including the ankle-brachial index, vascular Doppler ultrasound, and clinical examination to identify narrowings or blockages in the leg arteries.
Indication
- Leg pain, cramping, or stopping while walking (claudication)
- Non-healing wounds or color changes on the foot or leg
- Weak or absent foot pulses
- Atherosclerosis risk factors such as diabetes, smoking, hypertension, and hypercholesterolemia
- Lower extremity complaints in patients with known coronary or carotid artery disease
- Leg pain at rest or at night (suspected critical limb ischemia)
Preparation
- Rest in the supine position for at least 5-10 minutes before the procedure
- Remove thick socks and tight trousers
- If you smoke, avoid smoking for at least 2 hours before the measurement
- Inform the physician about blood pressure and vasodilator medications you are taking
How it's performed
- The patient is placed supine and cuffs are applied to the arm and ankle
- Systolic pressures are measured at ankle and arm arteries using a Doppler probe
- The ankle-to-arm pressure ratio (ABI) is calculated; an ABI < 0.9 supports PAD
- If needed, toe pressure (TBI), post-exercise ABI, or vascular Doppler ultrasound is added
- Findings are evaluated together with the clinical examination and reported
Post-procedure
- Smoking cessation, a regular walking program, and risk-factor control are recommended
- Statin, antiplatelet, and blood pressure therapies are arranged if needed
- In mild-to-moderate PAD, follow-up with ABI is planned every 6-12 months
- Early review is recommended if symptoms worsen or if a wound or rest pain develops
- In advanced cases, CT/MR angiography and evaluation for interventional treatment
Risks
- Temporary discomfort or bruising due to cuff pressure
- Falsely high readings in heavily calcified vessels (especially in diabetes)
- Risk of incorrect results from wrong cuff size or movement
- Increased pain during measurement in critical ischemia
FAQ
Is the ankle-brachial index measurement painful?
No. You feel a pressure similar to a regular blood pressure measurement; it is well tolerated by most patients.
How long does the ABI test take?
It is generally completed within 20-30 minutes; with an exercise protocol, it may take up to 45 minutes.
When are the results considered abnormal?
An ABI below 0.9 suggests peripheral artery disease, and a value below 0.4 may indicate advanced or critical ischemia.
If a vascular blockage is found, is surgery needed right away?
No. In many patients, smoking cessation, a walking program, and medication are sufficient; intervention is planned only in selected cases.
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