What is and ANKLE-BRACHIAL INDEX (ABI) Test?
An ABI test is a simple, reliable test for diagnosing PAD in the legs. The test measures the blood pressure in your ankles and compares it to that in your arms, while lying down comfortably in the office chair. The ABI test uses a hand-held ultrasound Doppler that is painless, and does not require entering the body.
Who might have an ABI test?
ABI should be performed annually on patients with at least one of these factors:
· every patient over 60 years old,
· every diabetic over 50 years old,
· current or former smokers over 50 years old,
· overweight,
· history of heart attack, stroke, TIAs, PAD
· history of vascular surgery, angioplasty, open heart surgery
· high blood pressure,
· high cholesterol.
Why do it?
It is simple, reliable, and safe, and the ABI test is usually the first test used to diagnose PAD in patients who have active symptoms such as leg discomfort, numbness, or non-healing sores. The ABI is also used to look for PAD in patients who do not have any symptoms, but are at risk for the disease because they have risk factors for PAD. In one large study, women with an ABI of 0.90 or less were 3.5 times as likely to die of heart disease within 10 years compared to women with a normal ABI – a silent killer.
ABI testing also helps document vascular disease when trying to meet Medicare qualifying criteria for medical necessity in the treatment and maintenance of mycotic nails or callus care.
In patients who have already been diagnosed with PAD, the ABI can monitor how severe your PAD is and help predict whether wounds will heal on their own. After a procedure to open leg arteries such as angioplasty, stenting, or lower-extremity bypass surgery, an ABI can indicate how effective the treatment was at improving blood flow in the leg.
What do the numbers mean?
A low ABI score means the blood pressure in your legs is lower than that in your arms, indicating that PAD is restricting blood flow to your legs. The lower your ABI score, the more severe your PAD is. A low ABI score also indicates you are at risk for other forms of artery disease, including coronary artery disease. A high ABI score can indicate arteries that are not compressible by the blood pressure cuff and are associated with hardening of the arteries versus a blockage within the artery.
*Patients who have a new suspected blood clot in the veins of the legs (deep vein thrombosis, or DVT) should not have an ABI test.
What happens next?
If you have only mild-to-moderate PAD, Dr. Pulapaka may start you on a walking program or she may decide to start you on a treatment plan and check your ABI again if your symptoms get worse.
If your ABI score indicates that you may have PAD, you may need more tests to examine blood flow in your leg arteries. This is usually accomplished by an Arterial Duplex Ultrasound. This will be scheduled in the office with our vascular technician. Once the Duplex is complete and the final report generated, Dr. Pulapaka will discuss the results with you on a follow-up appointment in the office.
How reliable is the ABI test at detecting PAD?
The ABI is one of the most accurate & simple tests for diagnosing PAD in the legs. Studies have shown that the ABI can identify about 90% of women with PAD, and fewer than 5% of women with a low ABI turn out not to have PAD.
As surrogate marker for atherosclerosis, the ABI score has been found to give very important prognostic information regarding future cardiovascular events. Current evidence suggests the use of ABI for identifying high risk patients for future cardiovascular and cerebrovascular mortality. In doing so, one can aggressively modify risk factors to prevent both short and long term events.
ABIs are a simple and effective why to help screen, control, and monitor PAD.
Risk Factors for Peripheral Arterial Disease
· Cigarette smoking
· Obesity
· Vascular/heart surgery
· Diabetes mellitus
· High blood pressure
· Physical inactivity
· High blood cholesterol
Signs and Symptoms of PAD
· Painful cramping of leg muscles during walking
· Burning/aching pain in the feet and toes while resting
· Toe and foot sores that do not heal
· Color changes in the skin
· Cooling of the skin in specific areas of legs or feet
Arrive at the office, unrushed and dressed comfortably, so that we can easily take your blood pressures on both arms and both legs without removing a lot of your clothing. Do not smoke for at least two hours prior to the test. You may eat as usual and take your medications as usual.
If you have not had or scheduled yours yet, call our office for your appointment today: 386-738-3733