Comparison of ankle-brachial index measured by an automated oscillometric apparatus with that by standard Doppler technique in vascular patients

Eur J Vasc Endovasc Surg. 2009 Nov;38(5):610-5. doi: 10.1016/j.ejvs.2009.07.004. Epub 2009 Sep 13.

Abstract

Objectives: To evaluate the determination of ankle-brachial indices (ABIs) using a simple automated ankle pressure measurement device in comparison with the Doppler technique.

Design: ABI was measured in 61 patients (122 legs) admitted to the department of vascular surgery, Rigshospitalet. ABI was calculated twice using both the methods on both legs.

Materials and methods: We tested the automated oscillometric blood pressure device, CASMED 740, for measuring ankle and arm blood pressure and compared it with the current gold standard, the hand-held Doppler technique, by the Bland-Altman analysis.

Results: Using the Doppler-derived ABI as the gold standard, the sensitivity and specificity of the oscillometric method for determining an ABI<or=0.9 is 71% and 92%, respectively. The overall accuracy for correctly identifying an ABI of 0.9 with the oscillometric method was 82%. Ankle pressures measured by CASMED 740 were systematically higher in patients with reduced ankle pressures, but accurate in patients with ankle pressures above 90 mm Hg.

Conclusion: Automated oscillometric assessment of ankle blood pressure and ABI may falsely categorise PAD patients as having a normal ankle pressure and ABI.

Publication types

  • Comparative Study
  • Evaluation Study

MeSH terms

  • Aged
  • Ankle / blood supply*
  • Arm / blood supply*
  • Automation
  • Blood Pressure Determination / instrumentation*
  • Blood Pressure*
  • Brachial Artery / diagnostic imaging*
  • Brachial Artery / physiopathology*
  • Humans
  • Middle Aged
  • Oscillometry / instrumentation
  • Peripheral Vascular Diseases / diagnosis*
  • Peripheral Vascular Diseases / diagnostic imaging
  • Peripheral Vascular Diseases / physiopathology
  • Predictive Value of Tests
  • Reproducibility of Results
  • Sensitivity and Specificity
  • Ultrasonography, Doppler*