INTRODUCTION: Peripheral arterial disease (PAD) had been shown to have a higher likelihood of developing cardiovascular events as well as cerebrovascular accidents particularly acute ischemic stroke. However, there are limited data on the association between ankle brachial index (ABI) values and the severity of ischemic stroke. This study aimed to determine the correlation of ABI values and the severity of acute ischemic stroke in Southern Philippines Medical Center. METHODS: A prospective cross-sectional study with 112 patients diagnosed with acute ischemic stroke from June to October 2017. The ABI ratio of the subjects were obtained and correlated with the severity of stroke using National Institutes of Health Stroke Scale (NIHSS). Data analyses utilized chi-square test for categorical variables while ANOVA test for continuous variables. Spearman rho was used to determine the association between ABI and NIHSS. RESULTS: Majority of patients with acute ischemic stroke had PAD with ABI ratio of ≤ 0.9 (51.8%). Using t-test, the NIHSS was significantly higher among patients with PAD having a mean score of 12.43 ± 5.29 compared to patients with normal ABI ratio having a mean score of 5.13 ± 4.09 (p= < 0.001). Furthermore, using Spearman’s rho statistics, ABI ratio was negatively correlated with NIHSS score (p < 0.001). CONCLUSION: Our results confirmed that there is a correlation between low ABI value and the severity of acute ischemic stroke. Routine ABI screening may help physicians intensify treatment strategies for those high-risk patients to prevent future events.
Ankle Brachial Index ; Peripheral Arterial Disease ; Stroke

Introduction: Peripheral Artery Disease (PAD) is a significant marker of cardiovascular disease and is prevalent but underdiagnosed. Ankle-Brachial Index (ABI) is the recommended screening test for PAD. However, not all clinics have a Doppler ultrasound. ABI by palpation offers a more feasible alternative. Objective: This study aims to determine the validity of ABI measurement by palpation method in the screening of PAD. Methodology: This prospective validation study utilized a cross-sectional analytic design. Three physicians performed the ABI by palpation method and their result was compared to the Doppler ABI. The accuracy indices for validation was computed per physician conducting the ABI by palpation and also as an average of all 3 palpation method readings. During the course of sampling, there were no patients with severe PAD found during the prospective period. Results: The accuracy of Ankle Brachial Index using Palpation method yielded the following ranges, sensitivity between 63.16 % - 73.68%, specificity of 94.06% - 98.02%, PPV within 85.37% - 95.45%, and NPV within 80.73% - 86.84% in predicting PAD. The accuracy indices were clinically acceptable. Meanwhile, the raters’ usage of Ankle Brachial Index using Palpation method demonstrated a substantial agreement with ABI by Doppler Method performed by the angiologist (Cohen Kappa >0.60). Conclusion The ABI by palpation is a good screening tool for PAD, but the person performing it must be adequately trained to do the procedure. The procedure is affordable and convenient, and should be done routinely during clinic visits in the physical examination of patients with known risk factors for PAD.
Diabetes Mellitus ; Ankle Brachial Index ; Palpation

No abstract available.
Ankle Brachial Index ; Arteries ; Humans ; Leg ; Mass Screening

PURPOSE: Early traditional methods of surveillance to detect failing graft relied on recurrence of symptoms, change of pedal pulses, or a decrease in the Ankle-Brachial Index (ABI). More recently, graft surveillance with Duplex scan which has become an appropriate first-line alternative has been shown to be effective in identifying the patency of threatened femorodistal graft. The purpose of this study was to determine the relationship and significance among ABI change, run-off resistance score, and Duplex scan parameters in femorodistal graft bypass. METHOD: Among 52 patients who received femorodistal bypass, thirty-one femorodistal grafts (19: above knee, 12: below knee) which had followed up for more than 2 years were followed up by ABI at regular interval and Duplex scan at 2 year. Those were grouped according to the grade of ABI decrease as follows; Group I: <0.1 ABI decrease, Group II: 0.1or= 0.2 ABI decrease. Peak systolic flow velocity (PSFV) ratio, luminal diameter at near proximal and distal anastomosis, mean body graft velocity (cm/sec) were evaluated. Runoff resistance score was calculated by the finding of the pre-operative angiogram. RESULT: In proportion to the severity of ABI decrease, proximal and distal peak systolic flow velocity (PSFV) ratio and stenosis (%) increased, mean body graft velocity decreased. Significant statistical difference between groups were shown as follows; Group II and IV: distal PSFV ratio (2.17 vs 2.95, P=0.02), proximal stenosis (32.8% vs 47.4%, P=0.026), distal stenosis (21.7% vs 62.0%, P=0.007), mean body graft velocity (81 cm/sec vs 46 cm/sec, P=0.02) Group III and IV: distal PSFV ratio (2.29 vs 2.95, P=0.02), distal stenosis (40.5% vs 62.0%; P=0.003), body flow velocity (70 cm/sec vs 46 cm/sec, P=0.02). The higher runoff resistance score was, the more distal PSFV ratio, distal stenosis increased, but proximal stenosis, PSFV ratio, and mean body graft velocity did not change significantly. CONCLUSION: This study shows that higher decrease in ABI (>0.2) is well correlated with critical Duplex parameters. Longer graft patency and economic benefit may be obtained by active evaluation of failing graft using by Duplex scan when the ABI decrease is more than 0.2 in femorodistal graft bypass at regular examination.
Ankle Brachial Index ; Constriction, Pathologic ; Humans ; Knee ; Phenobarbital ; Recurrence ; Transplants*

PURPOSE: We wanted to determine the incidence and characteristics of failing graft after implantation of autologous reversed vein grafts. METHOD: From Sep. 2003 to Dec. 2005, 84 leg bypasses using autologous reversed vein grafts were performed for chronic leg ischemia in 75 patients. After the operations, duplex ultrasonography (DUS) and measurement of the ankle brachial index (ABI) were performed every 3 months for the purpose of examining the graft patency. The criteria for a failing graft was a peak systolic velocity (PSV) of the stenotic lesion >300 cm/s, or a PSV distal to the occlusive lesion <40 cm/s, but with sustained patency of the vein graft. We investigated the timing of detection, the site of the causative lesion, and the clinical symptoms of the failing grafts. For the treatment of failing grafts, surgeries (vein patch, graft extension, or inflow artery reconstruction) were performed in 4 legs. The Kaplan Meier method was used for calculating the rate of graft patency. RESULT: Nine failing grafts were detected by DUS in 8 patients. The sites of causative lesions were the inflow artery (2), the proximal anastomosis (6), and the distal anastomosis (1). Seven of the 9 patients with failing grafts were asymptomatic, 1 patient had claudication and another patient suffered from resting pain of the involved leg. The assisted graft primary patency rates at 1 and 2 years after operations were 86% and 53%, respectively. CONCLUSION: Nine cases of failing grafts were detected during surveillance with duplex ultrasonography after implantation of autologous reversed vein grafts.
Ankle Brachial Index ; Arteries ; Diagnosis* ; Humans ; Incidence ; Ischemia ; Leg ; Lower Extremity* ; Transplants* ; Ultrasonography ; Veins

PURPOSE: The purpose of this study was to examine self care behaviors according to the risk levels of vascular complications in elderly women with hypertension. METHODS: The subjects of this study were 162 women living in the community who had been diagnosed with hypertension in clinics. The data were analysed by the SPSS 10.0 program using descriptive statistics, t-test, and ANOVA with Scheff. post-hoc test. RESULTS: The average self care behavior score of the elderly women was 2.79. Total self care behavior was significantly different depending on the risk levels of vascular complications such as systolic blood pressure, diastolic blood pressure, ankle-brachial index, and the framingham point score. Among sub-scores of self care behaviors, exercise management was the poorest performance compared with other self care behaviors. CONCLUSION: This study proved the differences in self care behaviors according to the risk levels of vascular complications. To decrease the prevalence of vascular complication, it is necessary to develop programs specifically to enhance self care behaviors of elderly women with hypertension.
Aged ; Ankle Brachial Index ; Blood Pressure ; Female ; Humans ; Hypertension ; Prevalence ; Self Care

BACKGROUND: Previous studies showed that great difference of inter-arm blood pressure (IABP) was associated with adverse cardiovascular outcomes. However, these studies had measurement bias because blood pressure (BP) was measured sequentially for each arm. Then, the aim of present study, using simultaneous BP measurement, is to investigate the association between ankle brachial index (ABI), brachial ankle pulse wave velocity (baPWV) and IABP difference in patients without cardiovascular disease. METHODS: We conducted cross sectional study from medical data and selected 153 (116 men, 37 women) patients aged 18 years or older. Simultaneous BP measurements were recorded using automatic oscillometric monitor equipped with dual arm cuffs in both arms. At the same day, ABI, baPWV, and physical parameters were evaluated. RESULTS: The mean age of the subjects was 52.8 +/- 9.9 and the difference of inter-arm systolic BP (SBP) and diastolic BP (DBP) were 5.6 +/- 4.3 and 4.5 +/- 3.7 mm Hg. Compared with group with an inter-arm SBP difference less than 5 mm Hg, group with an inter-arm SBP difference more than 5 mm Hg was more older (p = 0.012), more higher proportion of patient whose left arm SBP was higher than right (p = 0.004), higher left arm SBP (p = 0.044) and higher baPWV (p = 0.025). However, the difference of IABP in SBP and DBP had no significant correlation with the age (r = 0.152, p = 0.06 and r = 0.03, p = 0.715), ABI (r = 0.021, p = 0.801 and r = 0.131, p = 0.105) and baPWV (r = 0.115, p = 0.158 and r = 0.068, p = 0.403). CONCLUSIONS: There were no significant correlation between the differences of IABP in simultaneous BP measurements and ABI, baPWV.
Adult ; Ankle Brachial Index ; Atherosclerosis* ; Blood Pressure Determination* ; Blood Pressure ; Humans ; Pulse Wave Analysis

PURPOSE: The purpose of this study is to establish guidelines for ankle-brachial index (ABI), toe-brachial index (TBI) and toe pressure with regard to healing of diabetic foot amputation wound. MATERIAL AND METHODS: We designed a retrospective study that included patients with diabetic foot ulcer. From 2008 to 2011, 46 patients who had suffered from amputation of a foot due to diabetic foot ulcer were included in this study. We divided them into amputation-success group and amputation-revision group, and compared their ankle-brachial index (ABI), toe-brachial index (TBI) and toe pressure between two groups. Amputation-revision group is that first forefoot amputation is failed to heal successfully and need to have another proximal amputation. RESULTS: Toe pressure was 78 mmHg (54~107) in the amputation success group, 0 mmHg (0~43) in the amputation revision group (p=0.000). Ankle-brachial index was 1.1650(1.0475~1.1975) in the amputation success group, 0.92(0.5275~1.0750) in the amputation revision group (p=0.05), and toe-brachial index was 0.6100(0.4050~0.7575) in the amputation success group, 0.00(0.00~0.4150) in the amputation revision group (p=0.04), respectively. CONCLUSION: ABI, TBI, toe pressure of amputation success group were significantly higher than those of amputation revision group.
Amputation ; Ankle Brachial Index ; Diabetic Foot ; Foot ; Humans ; Retrospective Studies ; Toes ; Ulcer ; Wound Healing

A 27-year-old male was admitted with a three week history of pain and gangrenous changes of his first to fourth right foot toes. Clinical, laboratory and angiographic findings were consistent with Buerger's disease. The patient was treated by subintimal balloon angioplasty of the right anterior tibial artery. The percutaneous subintimal angioplasty was successful, and the patient symptoms and the ankle brachial index was improved. The value of subintimal angioplasty in limb-threatening ischemia in Buerger's disease, has not been established but this case illustrates a role for subintimal angioplasty in acute ischemia.
Adult ; Angioplasty ; Angioplasty, Balloon* ; Ankle Brachial Index ; Foot ; Humans ; Ischemia ; Male ; Thromboangiitis Obliterans* ; Tibial Arteries ; Toes

OBJECTIVETo evaluate the association between low ankle brachial index and risk of death.

METHODSRelated cohort studies in the past 12 years were collected. Heterogeneity was analyzed with χ(2) and I(2). Pooled hazard ratio (HR) as the effect indicator and 95% confidence interval (CI) were used to estimate the association of low ankle brachial index and risk of death by fixed effect model (inverse variance method).

RESULTSA total of 8 studies were included with sum sample size of 30 029. In heterogeneity analysis, χ(2) was 5.46, I(2) was 0.0%, and P was 0.604. Meta-analysis resulted in pooled HR of 1.69 (95%CI: 1.55 - 1.84).

CONCLUSIONLow ankle brachial index is associated with increased risk of death.