wrist brachial index interpretation

Contrast arteriography remains the gold standard for vascular imaging and at times can be a primary imaging modality, particularly if intervention is being considered. 13.14 ). The anatomy as shown in this chapter is sufficient to perform a comprehensive examination of the upper extremity arteries. Only tests that confirm the presence of arterial disease,further define the level and extent of vascular pathologyor provide information that will alter the course of treatment should be performed.Vascular testing may be indicated for patients with suspected arterial disease based upon symptoms (eg, intermittent claudication), physical examination findings (eg, signs of tissue ischemia), or in patients who are asymptomatic with risk factors for atherosclerosis (eg, smoking, diabetes mellitus) or other arterial pathology (eg, trauma, peripheral embolism) [1]. Why It Is Done Results Current as of: January 10, 2022 Exercise testing is a sensitive method for evaluating patients with symptoms suggestive of arterial obstruction when the resting extremity systolic pressures are normal. The lower the ABI, the more severe PAD. Patients can be asymptomatic, have classic symptoms of peripheral artery disease (PAD) such as claudication, or more atypical symptoms. Atherosclerotic obstruction of more distal arteries, such as the brachial, radial, and ulnar arteries, is less common; nevertheless, distal arteries may occlude secondary to low-flow states or embolization. Fasting is required prior to examination to minimize overlying bowel gas. Furthermore, the vascular anatomy of the hand described herein is a simplified version of the actual anatomy because detailing all of the arterial variants of the hand is beyond the scope of this chapter. (B) Doppler signals in these small arteries typically are quite weak and show blood flow features that differ from the radial and ulnar arteries. Ann Intern Med 2010; 153:325. Arch Intern Med 2003; 163:1939. Segmental pressures can be obtained for the upper or lower extremity. The Ankle Brachial Index (ABI) is a measure of ankle pressure divided by the pressure at the arm.

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