Volume 48, Issue 2 June 2024 JVU 482-83 | Utility of Toe-Brachial Index-482-83

482-83

Pdf Summary

The study by William Del Valle examines the utility of the toe-brachial index (TBI) alongside the ankle-brachial index (ABI) in diagnosing peripheral arterial disease (PAD), particularly in diabetic patients. The research compared duplex ultrasound findings with ABI and TBI values in 100 patients with suspected symptomatic PAD. The results showed low overall sensitivity for both ABI (62%) and TBI (56%), with slightly improved sensitivity in the presence of inflow disease. Specificity was good for both modalities, with ABI performing better in patients with diabetes. The study indicated that TBI may not add significant clinical value when used in conjunction with ABI.<br /><br />The diagnostic accuracy of TBI was found to be variable, particularly in diabetic patients, and there is a need for standardized normal values and improved consistency in testing procedures. While some studies suggest TBI compensates for ABI limitations in diabetics, this research found both indices had similar sensitivity and accuracy levels. The study recommends more research in this area of physiologic testing due to the limitations identified in this study.<br /><br />Overall, the research concluded that TBI, when used with ABI, demonstrated low sensitivity and moderate specificity, suggesting it may not be necessary as a routine evaluation tool for PAD. The study highlights the challenges in utilizing TBI effectively and emphasizes the need for further investigation in this field of physiologic testing.

Keywords

toe-brachial index

TBI

ankle-brachial index

ABI

peripheral arterial disease

PAD

duplex ultrasound

diabetic patients

sensitivity

specificity