Archives of Plastic Surgery

Korean Society of Plastic and Reconstructive Surgeons (대한성형외과학회)
권호 표지
DOI QR코드

DOI QR Code

Utility of Toe-brachial Index for Diagnosis of Peripheral Artery Disease

  • Park, Seong-Chul (Department of Plastic and Reconstructive Surgery, Soonchunhyang University Gumi Hospital, Soonchunhyang University College of Medicine) ;
  • Choi, Chang-Yong (Department of Plastic and Reconstructive Surgery, Soonchunhyang University Gumi Hospital, Soonchunhyang University College of Medicine) ;
  • Ha, Young-In (Department of Plastic and Reconstructive Surgery, Soonchunhyang University Gumi Hospital, Soonchunhyang University College of Medicine) ;
  • Yang, Hyung-Eun (Department of Plastic and Reconstructive Surgery, Soonchunhyang University Gumi Hospital, Soonchunhyang University College of Medicine)
  • Received : 2011.11.27
  • Accepted : 2012.03.09
  • Published : 2012.05.15
Download PDF
⟨ Previous Next ⟩

Abstract

Background : The ankle brachial pressure index (ABI) is a simple, useful method for diagnosing peripheral artery disease (PAD). Although the ABI is an objective diagnostic method, it has limited reliability in certain scenarios. The aim of the present study was to determine the accuracy and reliability of the toe brachial index (TBI) as a diagnostic tool for detecting stenosis in PAD, associated with normal or low ABI values. Methods : ABI and TBI values were measured in 15 patients with diabetic gangrene who were suspected of having lower extremity arterial insufficiency. The ABI and TBI values were measured using a device that allowed the simultaneous measurement of systolic blood pressure in the upper and lower extremities. In addition, the ABI and TBI values were compared pre- and post-angiography. Results : Patients with an ABI of 0.9-1.3 showed almost no difference between the 2 measurements. The patients with TBI >0.6 had no arterial insufficiency. The patients with TBI <0.6 required vascular intervention with ballooning. After the angiography, the gangrenous wounds decreased in size more rapidly than they did prior to the intervention. Conclusions : Our findings suggest that TBI is the method of choice for evaluating lower limb perfusion disorders. This result requires further studies of TBI in a larger number of patients. Future long-term studies should therefore evaluate the utility of TBI as a means of screening for PAD and the present findings should be regarded as preliminary outcomes.

Keywords

References

  1. Harrison ML, Lin HF, Blakely DW, et al. Preliminary assessment of an automatic screening device for peripheral arterial disease using ankle-brachial and toe-brachial indices. Blood Press Monit 2011;16:138-41. https://doi.org/10.1097/MBP.0b013e328346a839
  2. Suominen V, Rantanen T, Venermo M, et al. Prevalence and risk factors of PAD among patients with elevated ABI. Eur J Vasc Endovasc Surg 2008;35:709-14. https://doi.org/10.1016/j.ejvs.2008.01.013
  3. Diehm C, Schuster A, Allenberg JR, et al. High prevalence of peripheral arterial disease and co-morbidity in 6880 primary care patients: cross-sectional study. Atherosclerosis 2004;172:95-105. https://doi.org/10.1016/S0021-9150(03)00204-1
  4. Hirsch AT, Criqui MH, Treat-Jacobson D, et al. Peripheral arterial disease detection, awareness, and treatment in primary care. JAMA 2001;286:1317-24. https://doi.org/10.1001/jama.286.11.1317
  5. Martin Borge V, Herranz de la Morena L, Castro Dufourny I, et al. Peripheral arterial disease in diabetic patients: utility of the toe-brachial index. Med Clin (Barc) 2008;130:611-2. https://doi.org/10.1157/13120340

Cited by

  1. Predictive factors for successful limb salvage surgery in diabetic foot patients vol.14, pp.None, 2014, https://doi.org/10.1186/1471-2482-14-113
  2. Noninvasive Arterial Testing in Patients With Diabetes : A Guide for Foot and Ankle Surgeons vol.36, pp.12, 2012, https://doi.org/10.1177/1071100715593888
  3. Effect of patient positioning on toe pressure measurement using noninvasive vascular testing. vol.20, pp.suppl9, 2015, https://doi.org/10.12968/bjcn.2015.20.sup9.s12
  4. A systematic review of the sensitivity and specificity of the toe–brachial index for detecting peripheral artery disease vol.21, pp.4, 2012, https://doi.org/10.1177/1358863x16645854
  5. Toe-Brachial Index in the Second Toe: Substitutability to Toe-Brachial Index in the Great Toe and Ankle-Brachial Index vol.9, pp.4, 2016, https://doi.org/10.3400/avd.oa.16-00078
  6. 2016 AHA/ACC Guideline on the Management of Patients With Lower Extremity Peripheral Artery Disease : A Report of the American College of Cardiology/American Heart Association Task Force on Clinical vol.135, pp.12, 2017, https://doi.org/10.1161/cir.0000000000000471
  7. Osteoprotegerin concentration is associated with the presence and severity of peripheral arterial disease in type 2 diabetes mellitus vol.47, pp.2, 2018, https://doi.org/10.1024/0301-1526/a000682
  8. Critical limb ischemia: current challenges and future prospects vol.14, pp.None, 2012, https://doi.org/10.2147/vhrm.s125065
  9. Measurement of Toe-Brachial Indices in People with Subnormal Toe Pressures vol.108, pp.2, 2012, https://doi.org/10.7547/16-036
  10. Measurement of Toe-Brachial Indices in People with Subnormal Toe Pressures vol.108, pp.2, 2012, https://doi.org/10.7547/16-036
  11. The relationship of erectile dysfunction and subclinical cardiovascular disease: A systematic review and meta-analysis vol.23, pp.1, 2012, https://doi.org/10.1177/1358863x17725809
  12. Peripheral vascular disease assessment in the lower limb: a review of current and emerging non-invasive diagnostic methods vol.17, pp.None, 2012, https://doi.org/10.1186/s12938-018-0494-4
  13. Intravenous contrast‐free standardized exercise perfusion imaging in diabetic feet with ulcers vol.50, pp.2, 2012, https://doi.org/10.1002/jmri.26570
  14. Effect of Supervised Exercise Program on Individuals in Peripheral Arterial Disease with Type 2 Diabetes Mellitus - A Systematic Review vol.16, pp.3, 2012, https://doi.org/10.2174/1573399815666190524094842
  15. Clinical Utility of the Ankle-Brachial Index and Toe Brachial Index in Patients with Diabetic Foot Ulcers vol.16, pp.3, 2012, https://doi.org/10.2174/1573399815666190531093238
  16. Point of care device for diagnosing and treatment of diabetes related peripheral arterial disease vol.912, pp.None, 2020, https://doi.org/10.1088/1757-899x/912/6/062018
  17. Pole Test and Ankle-Brachial Index by Using Doppler Ultrasound for Peripheral Arterial Disease in End-Stage Renal Disease Patients vol.19, pp.4, 2012, https://doi.org/10.1177/1534734620951528
  18. A Multidisciplinary Approach to Managing Ischemic Wounds and Current Treatment Options vol.23, pp.7, 2012, https://doi.org/10.1007/s11936-021-00929-y