Non-invasive assessment of peripheral arterial disease: Automated ankle brachial index measurement and pulse volume analysis compared to duplex scan
نویسندگان
چکیده
OBJECTIVES This cross-sectional study aimed to individually and cumulatively compare sensitivity and specificity of the (1) ankle brachial index and (2) pulse volume waveform analysis recorded by the same automated device, with the presence or absence of peripheral arterial disease being verified by ultrasound duplex scan. METHODS Patients (n=205) referred for lower limb arterial assessment underwent ankle brachial index measurement and pulse volume waveform recording using volume plethysmography, followed by ultrasound duplex scan. The presence of peripheral arterial disease was recorded if ankle brachial index <0.9; pulse volume waveform was graded as 2, 3 or 4; or if haemodynamically significant stenosis >50% was evident with ultrasound duplex scan. Outcome measure was agreement between the measured ankle brachial index and interpretation of pulse volume waveform for peripheral arterial disease diagnosis, using ultrasound duplex scan as the reference standard. RESULTS Sensitivity of ankle brachial index was 79%, specificity 91% and overall accuracy 88%. Pulse volume waveform sensitivity was 97%, specificity 81% and overall accuracy 85%. The combined sensitivity of ankle brachial index and pulse volume waveform was 100%, specificity 76% and overall accuracy 85%. CONCLUSION Combining these two diagnostic modalities within one device provided a highly accurate method of ruling out peripheral arterial disease, which could be utilised in primary care to safely reduce unnecessary secondary care referrals.
منابع مشابه
Do ankle brachial index and pulse volume waveforms compare with the Ultrasound Duplex Scan for identifying Peripheral Arterial Disease?
Content of presentation 200 patients referred for UDS of lower limb arteries at two Medical Physics departments in the UK underwent an automated ABI and PVR measurement using a device utilising volume plethysmography followed by a UD Scan. PAD was recorded for automated ABI if <0.9 (and noted if >1.30), PVR’s if graded mild/moderate/severe and with a haemodynamically significant stenosis or occ...
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