Which statement describes the correct technique by a nurse when performing the ankle brachial pressure index test?

  1. Meijer WT, Hoes AW, Rutgers D, Bots ML, Hofman A, Grobbee DE. Peripheral arterial disease in the elderly. Rotterdam Stud. 1998;18(2):185–92.

    CAS  Google Scholar 

  2. Norman PE, Eikelboom JW, Hankey GJ. Peripheral arterial disease: prognostic significance and prevention of atherothrombotic complications. Med J Aust. 2004;181(3):150–4.

    Article  PubMed  Google Scholar 

  3. Bonham PA. Get the LEAD out: noninvasive assessment for lower extremity arterial disease using ankle brachial index and toe brachial index measurements. J Wound Ostomy and Continence Nurs. 2006;33(1):30–41.

    Article  Google Scholar 

  4. American Diabetes Association. Peripheral arterial disease in people with diabetes. Diabetes Care. 2003;26(12):3333–41.

    Article  Google Scholar 

  5. Jude EB, Oyibo SO, Chalmers N, Boulton AJM. Peripheral arterial disease in diabetic and nondiabetic patients: a comparison of severity and outcome. Diabetes Care. 2001;24(8):1433–7.

    Article  CAS  PubMed  Google Scholar 

  6. Aboyans V, Criqui MH, Abraham P, Allison MA, Creager MA, Diehm C, et al. Measurement and interpretation of the ankle-brachial index. A Scientific Statement From the American Heart Association. Circulation. 2012;126(24):2890–909.

    Article  PubMed  Google Scholar 

  7. Gerhard-Herman MD, Gornik HL, Barrett C, Barshes NR, Corriere MA, Drachman DE, et al. 2016 AHA/ACC guideline on the management of patients with lower extremity peripheral artery disease: executive summary. A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines 2016.

    Google Scholar 

  8. Norgren L, Hiatt WR, Dormandy JA, Nehler MR, Harris KA, Fowkes FGR. Inter-society consensus for the Management of Peripheral Arterial Disease (TASC II). J Vasc Surg. 2007;45(1):S5–S67.

    Article  PubMed  Google Scholar 

  9. Haigh K, Bingley J, Golledge J, Walker P. Peripheral arterial disease -screening in general practice. Aust Fam Physician. 2013;42:391–5.

    PubMed  Google Scholar 

  10. Al-Qaisi M, Nott DM, King DH, Kaddoura S. Ankle brachial pressure index (ABPI): an update for practitioners. Vasc Health Risk Manag. 2009;5:833–41.

    Article  PubMed  PubMed Central  Google Scholar 

  11. Nicolai SP, Kruidenier LM, Rouwet EV, Bartelink ML, Prins MH, Teijink JA. Ankle brachial index measurement in primary care: are we doing it right? Br J Gen Pract. 2009;59(563):422–7.

    Article  PubMed  PubMed Central  Google Scholar 

  12. Matzke S, Franckena M, Alback A, Railo M, Lepantalo M. Ankle brachial index measurements in critical leg ischaemia - the influence of experience on reproducibility. Scand J Surg. 2003;92:144–7.

    Article  CAS  PubMed  Google Scholar 

  13. Aboyans V, Lacroix P, Doucet S, Preux PM, Criqui MH, Laskar M. Diagnosis of peripheral arterial disease in general practice: can the ankle-brachial index be measured either by pulse palpation or an automatic blood pressure device? Int J Clin Pract. 2008;62.

  14. Staessen JA, Li Y, Wang J-G. Comparison of three measures of the ankle-brachial blood pressure index in a general population. Hypertens Res. 2007;30:555.

    Article  PubMed  Google Scholar 

  15. Ramanathan A, Conaghan PJ, Jenkinson AD, Bishop CR. Comparison of ankle-brachial pressure index measurements using an automated oscillometric device with the standard doppler ultrasound technique. ANZ J Surg. 2003;73(3):105–8.

    Article  PubMed  Google Scholar 

  16. Holland-Letz T, Endres HG, Biedermann S, Mahn M, Kunert J, Groh S, et al. Reproducibility and reliability of the ankle—brachial index as assessed by vascular experts, family physicians and nurses. Vasc Med. 2007;12(2):105–12.

    Article  PubMed  Google Scholar 

  17. Pollak EW, Chavis P, Wolfman EF. The effect of postural changes upon the ankle arterial perfusion pressure. Vasc Surg. 1976;10(4):219–22.

    Article  CAS  PubMed  Google Scholar 

  18. Pilli R, Naidu M, Pingali U, Takallapally RK. Study of cardiovascular effects of caffeine in healthy human subjects, with special reference to pulse wave velocity using photoplethysmography. Int J Nutr Pharmacol Neurol Dis. 2012;2(3):243–50.

    Article  CAS  Google Scholar 

  19. Waring WS, Goudsmit J, Marwick J, Webb DJ, Maxwell SR. Acute caffeine intake influences central more than peripheral blood pressure in young adults. Am J Hypertens. 2003;16(11 Pt 1):919–24.

    Article  CAS  PubMed  Google Scholar 

  20. Yataco AR, Gardner AW. Acute reduction in ankle/brachial index following smoking in chronic smokers with peripheral arterial occlusive disease. Angiology. 1999;50(5):355–60.

    Article  CAS  PubMed  Google Scholar 

  21. Carter SA. Response of ankle systolic pressure to leg exercise in mild or questionable arterial disease. N Engl J Med. 1972;287(12):578–82.

    Article  CAS  PubMed  Google Scholar 

  22. Chuter VH, Casey SL. Effect of premeasurement rest time on systolic ankle pressure. J Am Heart Assoc. 2013;2(4):e000203.

  23. Liberati A, Altman DG, Tetzlaff J, Mulrow C, Gotzsche PC, Ioannidis JP, et al. The PRISMA statement for reporting systematic reviews and meta-analyses of studies that evaluate health care interventions: explanation and elaboration. PLoS Med. 2009;6:e1000100.

    Article  PubMed  PubMed Central  Google Scholar 

  24. Borenstein M, Hedges LV, Higgins JP, Rothstein HR. A basic introduction to fixed-effect and random-effects models for meta-analysis. Res Synth Methods. 2010;1(2):97–111.

    Article  PubMed  Google Scholar 

  25. Lucas NP, Macaskill P, Irwig I, Bogduk N. The development of a quality appraisal tool for studies of diagnostic reliability. J Clin Epidemiol. 2010;63:854–61.

    Article  PubMed  Google Scholar 

  26. Jvd S, Verbogt NP, Mulder PG, Steunenberg SL, Steunenberg BE, Lvd L. The clinical applicability of an automated plethysmographic determination of the ankle-brachial index after vascular surgery. Vascular. 2016;24(5):545–8.

    Article  Google Scholar 

  27. Harrison ML, Lin H-F, Blakely DW, Tanaka H. Preliminary assessment of an automatic screening device for peripheral arterial disease using ankle–brachial and toe–brachial indices. Blood Press Monit. 2011;16(3):138–41.

    Article  PubMed  Google Scholar 

  28. Khandanpour N, Armon MP, Jennings B, Clark A, Meyer FJ. Photoplethysmography, an easy and accurate method for measuring ankle brachial pressure index: can photoplethysmography replace Doppler? Vasc Endovasc Surg. 2009;43(6):578–82.

    Article  Google Scholar 

  29. Bonham PA, Cappuccio M, Hulsey T, Michel Y, Kelechi T, Jenkins C, et al. Are ankle and toe brachial indices (ABI-TBI) obtained by a pocket Doppler interchangeable with those obtained by standard laboratory equipment? J Wound Ostomy Continence Nurs. 2007;34(1):35–44.

    Article  PubMed  Google Scholar 

  30. Raines JK, Farrar J, Noicely K, Pena J, Davis WW, Willens HJ, et al. Ankle/brachial index in the primary care setting. Vasc Endovasc Surg. 2004;38(2):131–6.

    Article  Google Scholar 

  31. Gestin S, Delluc A, Saliou AH, Colas A, Guéguen F, Gladu G, et al. Ankle brachial pressure index (ABPI): color-Doppler versus ultrasound Doppler correlation study in 98 patients after analysis of interobserver reproducibility. J Mal Vasc. 2012;37(4):186–94.

    Article  CAS  PubMed  Google Scholar 

  32. Kollias A, Xilomenos A, Protogerou A, Dimakakos E, Stergiou GS. Automated determination of the ankle-brachial index using an oscillometric blood pressure monitor: validation vs. Doppler measurement and cardiovascular risk factor profile. Hypertens Res. 2011;34(7):825–30.

    Article  PubMed  Google Scholar 

  33. Hamel J-F, Foucaud D, Fanello S. Comparison of the automated oscillometric method with the gold standard Doppler ultrasound method to access the ankle-brachial pressure index. Angiology. 2010;61(5):487–91.

    Article  PubMed  Google Scholar 

  34. Davies JH, Williams EM. Automated plethysmographic measurement of the ankle-brachial index: a comparison with the doppler ultrasound method. Hypertens Res. 2016;39(2):100–6.

    Article  PubMed  Google Scholar 

  35. Bundó M, Urrea M, Muñoz-Ortíz L, Pérez C, Llussà J, Forés R, et al. Measurement of the ankle brachial index with a non-mercury sphygmomanometer in diabetic patients: a concordance study. BMC Cardiovasc Disord. 2013;13(1):1–7.

    Article  Google Scholar 

  36. Fowkes FG, Housley E, Macintyre CC, Prescott RJ, Ruckley CV. Variability of ankle and brachial systolic pressures in the measurement of atherosclerotic peripheral arterial disease. J Epidemiol Community Health. 1988;42(2):128–33.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  37. Ena J, Lozano T, Verdú G, Argente CR, González VL. Accuracy of ankle–brachial index obtained by automated blood pressure measuring devices in patients with diabetes mellitus. Diabetes Res Clin Pract. 2011;92(3):329–36.

    Article  PubMed  Google Scholar 

  38. Chongthawonsatid S, Dutsadeevettakul S. Validity and reliability of the ankle-brachial index by oscillometric blood pressure and automated ankle-brachial index. J Res Med Sci. 2017;22:44.

    Article  PubMed  PubMed Central  Google Scholar 

  39. Alzamora MT, Baena-Díez JM, Sorribes M, Forés R, Toran P, Vicheto M. Peripheral Arterial Disease study (PERART): prevalence and predictive values of asymptomatic peripheral arterial occlusive disease related to cardiovascular morbidity and mortality. BMC Publ Health. 2007;7. https://doi.org/10.1186/1471-2458-7-348.

  40. Bakalakou K, Marinakos A, Nouli A, Taxiarchou E, Margariti C, Papanikitas K, et al. Efficacy of automatic blood pressure device to determine reliably the ankle brachial index (ABI). Eur J Intern Med. 2011;22:S9.

    Article  Google Scholar 

  41. Monti M, Calanca L, Alatri A, Mazzolai L. Accuracy of in-patients ankle-brachial index measurement by medical students. Vasa. 2016;45(1):43–8.

    Article  PubMed  Google Scholar 

  42. Nexøe J, Damsbo B, Lund JO, Munck A. Measurement of blood pressure, ankle blood pressure and calculation of ankle brachial index in general practice. Fam Pract. 2012;29(3):345–51.

    Article  PubMed  Google Scholar 

  43. Endres H, Hucke C, Holland-Letz T, Trampisch H-J. A new efficient trial design for assessing reliability of ankle-brachial index measures by three different observer groups. BMC Cardiovasc Disord. 2006;6(1):33.

    Article  PubMed  PubMed Central  Google Scholar 

  44. Weatherley BD, Chambless LE, Heiss G, Catellier DJ, Ellison CR. The reliability of the ankle-brachial index in the atherosclerosis risk in communities (ARIC) study and the NHLBI family heart study (FHS). BMC Cardiovasc Disord. 2006;6(1):1–11.

    Article  Google Scholar 

  45. Balkanay OO, Arapi B, Arslan C, Gurel SA. Reliability of ankle brachial index measurement by oscillometric blood pressure monitoring device. Heart Surg Forum. 2012;15:S66.

    Google Scholar 

  46. Chesbro SB, Asongwed ET, Brown J, John EB. Reliability of Doppler and stethoscope methods of determining systolic blood pressures: considerations for calculating an ankle-brachial index. J Natl Med Assoc. 2011;103(9):863–9.

    Article  PubMed  Google Scholar 

  47. Georgakarakos E, Papadaki E, Vamvakerou V, Lytras D, Tsiokani A, Tsolakaki O, et al. Training to measure ankle–brachial index at the undergraduate level: can it be successful? Int J Low Extrem Wounds. 2013;12(2):167–71.

    Article  PubMed  Google Scholar 

  48. Hv L, Jv G, Rubbens L. Interobserver variability of ankle–brachial index measurements at rest and post exercise in patients with intermittent claudication. Vasc Med. 2009;14(3):221–6.

    Article  Google Scholar 

  49. Špan M, Geršak G, Millasseau SC, Meža M, Košir A. Detection of peripheral arterial disease with an improved automated device: comparison of a new oscillometric device and the standard Doppler method. Vasc Health Risk Manag. 2016;12:305–11.

    Article  PubMed  PubMed Central  Google Scholar 

  50. Jaffer U, Elmagrabi AW, Cameron A, Osman I. Agreement of community-performed ankle brachial pressure indices (ABPI) with vascular laboratory performed assessment. Vasc Dis Manag. 2008;5(2):71–2.

    Google Scholar 

  51. Alvaro-Afonso FJ, Garcia-Morales E, Molines-Barroso RJ, Garcia-Alvarez Y, Sanz-Corbalan I, Lazaro-Martinez JL. Interobserver reliability of the ankle-brachial index, toe-brachial index and distal pulse palpation in patients with diabetes. Diab Vasc Dis Res. 2018;15(4):344–7.

    Article  PubMed  Google Scholar 

  52. Demir O, Tasci I, Acikel C, Saglam K, Gezer M, Acar R, et al. Individual variations in ankle brachial index measurement among Turkish adults. Vascular. 2016;24(1):53–8.

    Article  PubMed  Google Scholar 

  53. Faccenda F, Rubba P, Vaccaro O, Carbone L, Pauciullo P, Riccardi G. Reproducibility of non-invasive vascular diagnosis in patients with diabetes mellitus. Artery. 1989;16(4):189–207.

    CAS  PubMed  Google Scholar 

  54. Millen RN, Thomas KN, Majumder A, Hill BG, Van Rij AM, Krysa J. Accuracy and repeatability of the Dopplex Ability. Expert Review of Medical Devices. 2018;15(3):247–51.

    Article  CAS  PubMed  Google Scholar 

  55. Rosenbaum D, Rodriguez-Carranza S, Laroche P, Bruckert E, Giral P, Girerd X. Accuracy of the ankle-brachial index using the SCVL(®), an arm and ankle automated device with synchronized cuffs, in a population with increased cardiovascular risk. Vasc Health Risk Manag. 2012;8:239–46.

    Article  PubMed  PubMed Central  Google Scholar 

  56. Chesbro SB, Asongwed ET, John EB, Haile N. Reliability of ankle-brachial index measurements: a comparison of standard and vascular blood pressure cuffs. Top Geriatr Rehabil. 2013;29(3):195–202.

    Article  Google Scholar 

  57. de Graaff JC, Ubbink DT, Legemate DA, de Haan RJ, Jacobs MJHM. Interobserver and intraobserver reproducibility of peripheral blood and oxygen pressure measurements in the assessment of lower extremity arterial disease. J Vasc Surg. 2001;33(5):1033–40.

    Article  PubMed  Google Scholar 

  58. Sonter JA, Chuter V, Casey S. Intratester and intertester reliability of toe pressure measurements in people with and without diabetes performed by podiatric physicians. J Am Podiatr Med Assoc. 2015;105(3):201–8.

    Article  PubMed  Google Scholar 

  59. Christensen NJ. Spontaneous variations in resting blood flow, postischaemic peak flow and vibratory perception in the feet of diabetics. Diabetalogia. 1969;5(3):171–8.

    Article  CAS  Google Scholar 

  60. Hilsted J, Parving HH, Christensen NJ, Benn J, Galbo H. Hemodynamics in diabetic orthostatic hypotension. J Clin Invest. 1981;68(6):1427–34.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  61. Schröder F, Diehm N, Kareem S, Ames M, Pira A, Zwettler U, et al. A modified calculation of ankle-brachial pressure index is far more sensitive in the detection of peripheral arterial disease. J Vasc Surg. 2006;44(3):531–6.

    Article  PubMed  Google Scholar 

  62. Niazi K, Khan TH, Easley KA. Diagnostic utility of the two methods of ankle brachial index in the detection of peripheral arterial disease of lower extremities. Catheter Cardiovasc Interv. 2006;68(5):788–92.

    Article  PubMed  Google Scholar 


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