课件：外周动脉疾病及其诊断方法.ppt

Measuring Ankle-Brachial Index (ABI) To confirm diagnosis of PAD the ABI can be measured in a primary care or hospital setting using a standard blood pressure cuff and handheld Doppler ultrasound device in the 7 MHz range. The ABI can be measured in a primary care or hospital setting to confirm diagnosis of PAD. An ordinary BP cuff is positioned over the upper arm and inflated above SBP. A Doppler ultrasonic velocity signal probe is then placed over the brachial artery to detect the resumption of blood flow with cuff deflation. Measurement of SBP is repeated on the other arm. If a discrepancy exists, the higher of the 2 SBP values is used. For measurement of ankle SBP, the BP cuff is moved to the ankle and blood flow resumption is detected with the Doppler probe over the posterior tibial (PT) artery and then over the dorsalis pedis (DA) artery. Again, if there is a discrepancy in SBP between the 2 arteries, the higher value is used. The process should be repeated for the other leg. Ankle pressure should always be measured with the patient lying on their back. Two measurements should be taken and the average recorded. The lowest ABI between both legs is the ABI that stratifies the patient’s risk for a poor outcome. An ABI test allows for PAD detection at all stages of the disease process. Acknowledgement: video courtesy of Dr Christophe Giot (BMS Belgium) PAD can be silent or cause symptoms ranging from exertional pain to critical limb ischemia Typical symptoms Approximately one-third of symptomatic patients present with typical claudication.1 Intermittent claudication (pain, ache, cramp, numbness, muscle fatigue in calves, thighs or buttocks; it is exacerbated by exercise and relieved by rest) The progression to critical limb ischemia is marked by the presence of pain at rest and development of nonhealing wounds or gangrene. This pain usually occurs distal to the arterial narrowing or obstruction and is most often localized to the calf because the vessels most