Correlation of the Resting and Exercise Doppler Ankle/Arm Index to Angiographic Findings

Abstract

The diagnosis of peripheral vascular occlusive disease has until recently been confirmed only through angiography. However, a noninvasive diagnostic test using Doppler-shift ultrasonography has shown great promise as a method of refining the diagnosis of peripheral vascular occlusive disease. The purpose of this study was to correlate the ankle/arm index (resting versus exercise) to the arteriographic findings and to outline a practical grading system of the se verity of the occlusive disease based on our Doppler index findings. From 500 arterial Doppler studies of 500 patients (1,000 limbs) at the Arizona Heart Insti tute, 93 limbs that had arteriograms and resting and exercising ankle/arm in dices were examined. The resting index was found to be an insensitive index of the severity of the disease. The exercise index did correlate very well with the arteriographic findings: 85% of patients with an excercise index greater than 0.9 were normal or had minimal disease. Most patients with an index of 0.8 to 0.89 had mild disease; 75% of patients with an index of 0.7 to 0.79 had moderate dis ease ; 98% of patients with index of less than 0.69 had severe disease.