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Measurement is done with the patient lying flat, with feet at heart level, using sphygmomanometry: the big toe is slightly emptied of blood by squeezing, and a small cuff is inflated around the base of the toe. Cuff pressure is then slowly lowered until flow can be detected in the distal part of the toe, e.g. by optical means (photocell), by ...
The ankle-brachial pressure index (ABPI) or ankle-brachial index (ABI) is the ratio of the blood pressure at the ankle to the blood pressure in the upper arm (brachium). Compared to the arm, lower blood pressure in the leg suggests blocked arteries due to peripheral artery disease (PAD).
Ankle-brachial pressure index (ABPI) assesses peripheral vascular disease. It may however be unreliable in patients with calcified arteries in the calf (often diabetic patients) or those with extensive oedema, in which case toe pressure or Toe-brachial pressure index (TBPI) should be measured to aid in the diagnosis.
Critical limb ischemia is diagnosed by the presence of ischemic rest pain, and an ulcers that will not heal or gangrene due to insufficient blood flow. [3] Insufficient blood flow may be confirmed by ankle-brachial index (ABI), ankle pressure, toe-brachial index (TBI), toe systolic pressure, transcutaneous oxygen measurement (TcpO2 ), or skin perfusion pressure (SPP).
The ABI is a simple, non-invasive test that measures the ratio of systolic blood pressure in the ankle to the systolic blood pressure in the upper arm. This is based on the idea that if blood pressure readings in the ankle are lower than those in the arm, a blockage in the arteries that provide blood from the heart to the ankle is suspected. [ 55 ]
To perform the test, one set of electrodes are placed on viable tissue (e.g. the chest) as a control and a second set is placed around the tissue in question (e.g. legs or feet). The electrodes may mildly heat the skin to increase blood flow into the area. Oxygen may also be given to the patient to see if that increases oxygen levels in the tissue.
Korotkoff sounds are the sounds that medical personnel listen for when they are taking blood pressure using a non-invasive procedure. They are named after Nikolai Korotkov , a Russian physician who discovered them in 1905, [ 1 ] when he was working at the Imperial Medical Academy in St. Petersburg , the Russian Empire.
Vascular doctors and nurses may use special pads to ensure uniform higher pressure around the circumference of the ankle (to smooth out the irregular cross-sectional profile.) Self-prescription is reasonably safe assuming that the compression gradient is 15–20 mmHg, the ABPI (for both legs) is >1.0 and that the stockings fit correctly.