Limitation of the resting ankle-brachial index in symptomatic patients with peripheral arterial disease

@article{Stein2006LimitationOT,
  title={Limitation of the resting ankle-brachial index in symptomatic patients with peripheral arterial disease},
  author={Russell Stein and Ingrid Hriljac and Jonathan L. Halperin and Susan M Gustavson and Victoria J. Teodorescu and Jeffrey W. Olin},
  journal={Vascular Medicine},
  year={2006},
  volume={11},
  pages={29 - 33}
}
Peripheral arterial disease (PAD) has been demonstrated to be prevalent in the primary care setting. However, it has also been shown to be unrecognized and under-treated. Owing to the association with cardiovascular disease it has been recommended to screen high-risk patients for PAD in the primary care setting using the ankle-brachial index (ABI). ABI has been demonstrated to be highly sensitive and specific in diagnosing PAD in patients with significant stenosis. However, the utility in… 
Combination of the ankle-brachial index and percentage of mean arterial pressure to improve diagnostic sensitivity for peripheral artery disease
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TLDR
DUS-derived ACCmax is an accurate marker that could offer significant benefits for the diagnosis of PAOD, especially in diabetic patients, according to retrospective analysis.
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References

SHOWING 1-10 OF 28 REFERENCES
Ankle-brachial index as a predictor of the extent of coronary atherosclerosis and cardiovascular events in patients with coronary artery disease.
TLDR
ABI is a simple index related to the extent of atherosclerosis in coronary and noncoronary arterial beds, reflecting generalized Atherosclerosis, and could be useful in assessing the risk for cardiovascular events in patients with coronary artery disease.
Critical evaluation of stress testing in the diagnosis of peripheral vascular disease.
TLDR
Routine stress testing is not cost effective, adding little diagnostic information to RAI, and it should be reserved for the small subset of symptomatic patients with normal RAI.
Peripheral arterial disease - epidemiological aspects
TLDR
PAD is under-recognized and under-treated, even though it should be regarded as a severe disease leading to significant death and disability from stroke and myocardial infarction, and accurate diagnosis of PAD could provide an early indication of the need for intervention and help prevent future morbidity and mortality.
Prevalence and significance of unrecognized lower extremity peripheral arterial disease in general medicine practice
TLDR
Unrecognized PAD is common among men and women aged 55 years and older in GIM practice and is associated with impaired lower extremity functioning and Ankle brachial index screening may be necessary to diagnose unrecognized P AD in a G IM practice.
Clinical measurement of systolic pressures in limbs with arterial occlusive disease.
TLDR
Pressure measurements are helpful in the evaluation of cases with doubtful arterial disease, in selection of patients for arterial surgery, in the objective assessment of the results of treatment, and in the follow-up of patients.
Mortality over a period of 10 years in patients with peripheral arterial disease.
TLDR
A 15-fold increase in rates of mortality due to cardiovascular disease and coronary heart disease among subjects with large-vessel peripheral arterial disease that was both severe and symptomatic was revealed.
Doppler ankle pressure: an evaluation of three methods of expression.
TLDR
It appears that ankle index and gradient are most appropriate for defining the presence of disease, while absolute pressure correlates best with viability.
Response of ankle systolic pressure to leg exercise in mild or questionable arterial disease.
  • S. Carter
  • Medicine
    The New England journal of medicine
  • 1972
TLDR
In 37 normal limbs ankle pressure after exercise either remained above or fell only a few millimeters of mercury below the brachial systolic pressure, thus useful in the assessment of patients with mild or questionable arterial disease.
Relationship of High and Low Ankle Brachial Index to All-Cause and Cardiovascular Disease Mortality: The Strong Heart Study
TLDR
The data suggest that the upper limit of normal ABI should not exceed 1.40, highlighting a U-shaped association between this noninvasive measure of peripheral arterial disease and mortality risk.
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