Ankle Peak Systolic Velocity Correlates with Toe Pressure in Patients with Peripheral Artery Disease

Abstract

Background

Conventional screening of Peripheral Artery Disease (PAD) with Ankle Brachial Index may be limited in diabetic patients due to arterial calcification. Alternatively, ankle peak systolic velocity (APSV) may be a more accurate measure of limb perfusion in those patients. This study aims to assess the correlation between APSV and toe pressure (TP) in patients evaluated for PAD.

Methods

This is a single-center retrospective study examining the correlation between APSV and TP in patients evaluated for PAD at a tertiary medical center between January 2019 and August 2020. Spearman Correlation and multivariate linear regression were used to assess the association between APSV and TP. The optimal cutoffs for APSV corresponding to TP of 30 mm Hg and 50 mm Hg were generated using the Youden index.

Results

A total of 224 patients with median age of 72 years were included in this study. 61% of patients were females and 54% were diabetic. The mean APSV of the overall population was 62 cm/s. APSV was significantly correlated with TP (R = 0.6, P < 0.001) in both diabetic and nondiabetic patients. On multivariate analysis, TP was significantly associated with APSV (estimate B 0.41, 95% confidence interval 0.29–0.53, P < 0.001). The optimal cutoffs of APSV to detect a TP ≤ 30 mm Hg and TP ≥ 50 mm Hg were 35 cm/s and 44 cm/s, respectively.

Conclusion

APSV is a reliable measure for evaluating perfusion in PAD patients. Its adoption in the clinical setting can significantly improve the accuracy of PAD diagnosis, allowing earlier detection and treatment.