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It is used primarily for blood pressure measurement (picture 1). 13.20 , than on the left because the right subclavian artery is a branch of the innominate artery and often has a good imaging window. Ankle Brachial Index | Time of Care Not only are the vessels small, there are numerous anatomic variations. Generally, three cuffs are used with above and below elbow cuffs and a wrist cuff. Leng GC, Fowkes FG, Lee AJ, et al. Diabetes Care 1989; 12:373. http://www.iwgdf.org/index.php?option=com_content&task=view&id=43&Itemid=63. Did the pain or discomfort come on suddenly or slowly? Ankle-Brachial Index (ABI) Measurement Technique - Medscape (See 'Ankle-brachial index'above.). Latent Class Analysis - ScienceDirect Eur J Radiol 2004; 50:303. During the diagnostic procedure, your provider will compare the systolic blood pressure in your legs to the blood pressure in the arms. It is a screen for vascular disease. The analogous index in the upper extremity is the wrist-brachial index (WBI). The brachial artery continues down the arm to trifurcate just below the elbow into the radial, ulnar, and interosseous (or median) arteries. Hiatt WR. Ann Intern Med 2002; 136:873. Diagnostic performance of computed tomography angiography in peripheral arterial disease: a systematic review and meta-analysis. Surg Forum 1972; 23:238. The dynamics of blood flow across a stenotic lesion depend upon the severity of the obstruction and whether the individual is at rest or exercising. 13.19 ), no detectable flow in the occluded vessel lumen with color and power Doppler (see Fig. PAD also increases the risk of heart attack and stroke. Specialized imaging of the hand can be performed to detect disease of the digital arteries. Compared with the cohort with an index >0.9, this group had markedly increased relative risks of 3.1 and 3.7 for death and coronary heart disease, respectively, at four years [, In a report from the Framingham study of 251 men and 423 women (mean age 80 years), 21 percent had an ABI <0.9 [, In a study of 262 patients, the ankle brachial index was measured in patients with type 2 diabetes [, The Multi-Ethnic Study of Atherosclerosis (MESA) study evaluated 4972 patients without clinical cardiovascular disease and found a greater left ventricular mass index in patients with high ABI (>1.4) compared with normal ABI (90 versus 72 g/m2) [, The Strong Heart Study followed 4393 Native American patients for a mean of eight years [. These objectives are met by obtaining one or more tests including segmental limb pressures, calculation of index values (ankle-brachial index, wrist-brachial index, toe-brachial index), pulse volume recordings, exercise testing, digit plethysmography and transcutaneous oxygen measurements.