Anatomic correlates of supra‐normal ankle brachial indices. Issue 6 (12th February 2013)

• Record Type: Journal Article
• Authors: Weinberg, Ido; Giri, Jay; Calfon, Marcella A.; Hawkins, Beau M.; Weinberg, Mitchell D.; Margey, Ronan; Hannon, Kathleen; Schainfeld, Robert M.; Jaff, Michael R.
• Is Part Of: Catheterization and cardiovascular interventions. Volume 81:Issue 6(2013:May 01)
• Page Start: 1025
• Page End: 1030
• Publication Date: 2013-02-12
• Subjects: Heart -- Diseases -- Diagnosis -- Periodicals; Cardiac catheterization -- Periodicals; 616.1207572
• DOI: 10.1002/ccd.24604
• Languages: English
• ISSNs: 1522-1946

Abstract

<abstract abstract-type="main"> <title> <x xml:space="preserve">Abstract</x> </title> <sec id="ccd24604-sec-0001" sec-type="section"> <title>Background</title> <p>Supra‐normal ankle brachial index (ABI) (>1.40), poses diagnostic challenges to determine the presence, location, and severity of peripheral artery disease (PAD). The anatomic distribution of PAD in patients with elevated ABI has not been previously described.</p> </sec> <sec id="ccd24604-sec-0002" sec-type="section"> <title>Methods</title> <p>A retrospective review of all patients referred to the Massachusetts General Hospital vascular diagnostic laboratory from 5 January 2006 to 12 January 2011 who had both a supra‐normal ABI and contrast arteriography (CA) within 3 months of each other is reported. Angiographic patterns were described using the Trans Atlantic Inter Society Consensus II (TASC II) classification.</p> </sec> <sec id="ccd24604-sec-0003" sec-type="section"> <title>Results</title> <p>One‐hundred sixteen limbs were analyzed in 92 patients. Mean age was 71.6 years (±11.2); 81.5% (75/92) were male; 85.9% Caucasian (79/92); 67.4% diabetics (62/92); 78.3% hypertensive (72/92); 67.4% hypercholesterolemic (62/92); and 64.1% were current or former tobacco users (59/92). Chronic hemodialysis was present in 18.5% (17/92) and 15.2% (14/92) received chronic corticosteroids. Intermittent claudication was present in 46.7% (43/92) and critical limb ischemia in 52.2% (48/92). Aortoiliac, femoral and infra‐popliteal involvement per angiography occurred in 14.9% (15/101), 56.1% (60/107), and 84.0% (84/100), respectively. Multilevel disease was present in 48.8% (42/86) of patients. PAD was absent in 4.7% (4/86) of patients. Toe brachial index <0.7 was found in 92% (92/100) of patients with angiographically confirmed PAD.</p> </sec> <sec id="ccd24604-sec-0004" sec-type="section"> <title>Conclusion</title> <p>In symptomatic patients referred to a vascular laboratory who were found to have supra‐normal ABI, nearly one half exhibited multilevel PAD, and over 80% had infrapopliteal involvement. A supra‐normal ABI in such patients mandates evaluation for the presence and extent of PAD. © 2013 Wiley Periodicals, Inc.</p> </sec> </abstract>