Hidden dangers revealed by misdiagnosed peripheral arterial disease using ABPI measurement

Abstract

Aim: The aim of this study was to compare ankle brachial indices (APBI) with pedal wave-forms utilizing the continuous wave Doppler in a population with diabetes mellitus. Methods: A prospective study design was employed to investigate the ABPI in a cohort of 49 people with type 2 diabetes mellitus. ABPI assessment was completed using a portable handheld Doppler and ankle pressures of <0.9 were taken as suggestive of peripheral arterial disease (PAD). Arterial spectral waveforms in each foot were also recorded and compared to the ABPI readings. Results: Inconsistencies were identified between ABPIs and waveform interpretations in the study population. Approximately 35% of subjects had inconsistencies between their ABPI result and waveform interpretation in their right or left foot. Conclusions: Both ABPIs and Doppler waveforms should be used in the assessment of people with diabetes in order to screen for PAD. This would ensure an accurate assessment of PAD and would allow initiation of appropriate secondary risk factor control measures.