Pocket Doppler and vascular laboratory equipment yield comparable results for ankle brachial index measurement.
BACKGROUND
The ankle brachial index (ABI) is a well-established tool for screening and diagnosis of peripheral arterial disease (PAD). In this study we assessed the validity of ABI determination using a pocket Doppler device compared with automatic vascular laboratory measurement in patients suspected of PAD.


METHODS
Consecutive patients with symptoms of PAD referred for ABI measurement between December 2006 and August 2007 were included. Resting ABI was determined with a pocket Doppler, followed by ABI measurement with automatic vascular laboratory equipment, performed by an experienced vascular technician. The leg with the lowest ABI was used for analysis.


RESULTS
From 99 patients the mean resting ABI was 0.80 measured with the pocket Doppler and 0.85 measured with vascular laboratory equipment. A Bland-Altman plot demonstrated great correspondence between the two methods. The mean difference between the two methods was 0.05 (P < .001). Multivariate linear regression analysis showed no dependency of the difference on either the average measured ABI or affected or unaffected leg.


CONCLUSIONS
Since the small, albeit statistically significant, difference between the two methods is not clinically relevant, our study demonstrates that ABI measurements with pocket Doppler and vascular laboratory equipment yield comparable results and can replace each other. Results support the use of the pocket Doppler for screening of PAD, allowing initiation of cardiovascular risk factor management in primary care, provided that the equipment operator is experienced.
Department of Surgery, Atrium medical center, Henri Dunantstraat 5, 6419 PC Heerlen, the Netherlands. exitpad@gmail.com
Saskia P A
SP
Nicolaï
Lotte M
LM
Kruidenier
Ellen V
EV
Rouwet
Liliane
L
Wetzels-Gulpers
Constantijn A M
CA
Rozeman
Martin H
MH
Prins
Joep A W
JA
Teijink
D000368:Aged; D000842:Ankle / Q000098:blood supply*; D001794:Blood Pressure; D001795:Blood Pressure Determination / Q000295:instrumentation*; D001916:Brachial Artery / Q000000981:diagnostic imaging* / Q000503:physiopathology; D005260:Female; D006801:Humans; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D016491:Peripheral Vascular Diseases / Q000000981:diagnostic imaging*; D011237:Predictive Value of Tests; D015203:Reproducibility of Results; D019722:Sphygmomanometers; D018608:Ultrasonography, Doppler / Q000295:instrumentation*