The Journal of Vascular Diseases Comparison of Lower Limb Arterial Assessments Using Color-Duplex Ultrasound and Ankle/Brachial Pressure Index Measurements

The strength of agreement between two noninvasive methods of assessing lower limb arterial disease and their relationship to patient symptoms following exercise have been investigated. Color-duplex ultrasound (CDU) and ankle/brachial pressure index (ABPI) (before and after exercise) measurements were obtained from 200 consecutive patients referred to a vascular investigations laboratory. From these patients, 290 limbs were available for study, comprising limbs without previous vascular surgery, from patients without diabetes and who could attempt a walking exercise test. The overall level of agreement between CDU and resting ABPI measurements was 83 % (Kappa 0.66). The ABPI technique identified the more serious disease; a resting ABPI of less than 0.6 gave 100 % agreement with CDU. With higher resting ABPIs the level of agreement became poorer: 83 % (0.6 ≤ ABPI < 0.9) and 76 % (normal ABPI ≥ 0.9). The addition of postex-ercise ABPI measurements in determining significant arterial disease increased the (continued on next page) at PENNSYLVANIA STATE UNIV on September 15, 2016ang.sagepub.comDownloaded fro