Ankle-Brachial Index
Applied
Type
ModificationConfidence
95%
Created
Mar 19, 2026
Evidence
2 sources
Rationale
The integration focuses on updating the guideline section with the 2024 ACC/AHA/SVS multi-society document, which is the current gold standard for PAD management. The systematic review by Uyagu et al. (2022) was added to support the consistency of these recommendations across various international guidelines. Abbreviations were expanded on first use as per instructions.
Evidence
Content Changes
removedadded
* **Definition:** ratio of ankle systolic pressure to brachial systolic pressure. * **Normal values:** 1.00–1.40. * **peripheral**Peripheral arterial disease (PAD) diagnosis:** <0.90 indicates peripheral arterial disease;PAD; <0.50 indicates severe ischemia. * **Noncompressible arteries:** Values >1.40 suggest medial arterial calcification (common in diabetes and chronic kidney disease).disease (CKD)). In such cases, measure toe pressures and toe-brachial index (TBI) instead. * **Exercise testing:** If symptoms suggest PAD but resting ankle-brachial index (ABI) is normal,normal or borderline (0.91–0.99), perform post-exercise ABI. A decrease ≥20% in ABI or ≥30 mmHg drop in ankle pressure supports the diagnosis. * **Guidelines:** The 2024 ACC/AHA/SVS guideline reaffirms ABI as the primary diagnostic test for PAD [@svs2024]. Previous recommendations from AHA/ACC (2016) and ESC (2017) also recommend ABI as first-line screening, with exercise ABI and toe-brachial index (TBI)TBI when indicated. [@aboyans2012]indicated [@aha2016] [@esc2017] [@potier2011][@uyagu2022].