title: Photoplethysmography and continuous-wave Doppler ultrasound as a complementary test to ankle-brachial index in detection of stenotic peripheral arterial disease.
abstract: OBJECTIVE
  We evaluated the sensitivity and specificity of ankle-brachial index (ABI), photoplethysmography (PPG), and continuous-wave Doppler ultrasound (CWD) in the detection of anatomically stenotic peripheral arterial disease (PAD).
  
  
  METHODS
  Ninety-seven patients (194 legs) patients who had coincidentally undergone computed tomography angiography (CTA), ABI, PPG, and CWD for the evaluation of PAD were retrospectively reviewed. Sensitivity and specificity were measured.
  
  
  RESULTS
  Among 194 legs, 163 (84%) legs had stenotic PAD on CTA. Overall sensitivity of ABI, PPG, and CWD was 69.3%, 81.6%, and 90.8% and specificity was 96.8%, 77.4%, and 64.5%, respectively. Ankle-brachial index showed a statistically significantly decreased sensitivity (14.8%) for below trifurcation level stenosis compared with CWD (92%) and PPG (67%). The sensitivity of ABI was also significantly decreased in single level and moderate stenosis (45.1% and 42.1%, respectively). In contrast, the sensitivity of CWD and PPG was not significantly decreased.
  
  
  CONCLUSIONS
  The ABI showed significantly decreased sensitivity especially in stenosis below the trifurcation level. Both PPG and CWD were complementary to ABI in these groups of patients.
authors.affiliation: Department of Orthopaedic Surgery, Seoul National University College of Medicine, Seoul, South Korea.
authors.forename: Du Hyun
authors.initials: du H
authors.lastname: Ro
authors.forename: Hyuk Ju
authors.initials: HJ
authors.lastname: Moon
authors.forename: Ji Hyeung
authors.initials: JH
authors.lastname: Kim
authors.forename: Kyoung Min
authors.initials: KM
authors.lastname: Lee
authors.forename: Sung Ju
authors.initials: SJ
authors.lastname: Kim
authors.forename: Dong Yeon
authors.initials: DY
authors.lastname: Lee
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D055109:Ankle Brachial Index; D003251:Constriction, Pathologic; D005260:Female; D006801:Humans; D035002:Lower Extremity / Q000098:blood supply*; D008297:Male; D008875:Middle Aged; D058729:Peripheral Arterial Disease / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000503:physiopathology; D017156:Photoplethysmography; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed; D018608:Ultrasonography, Doppler; D055815:Young Adult