Toe-Brachial Index

in Vascular Diagnostics and Imaging

Applied

Type

Reinforcement

Confidence

95%

Created

Mar 19, 2026

Evidence

1 source

Rationale

The 2025 ACC Scientific Statement on PAD in diabetes provides high-level evidence reinforcing the utility of TBI when ABI is unreliable due to calcification. The integration expands abbreviations as required and adds specific clinical parameters (ABI >1.40) that warrant TBI assessment.

Evidence

Das SR et al. Management of Peripheral Artery Disease in Adults With Diabetes: 2025 ACC Scientific Statement: A Report of the American College of Cardiology. J Am Coll Cardiol. 2025. PMID: 41405527.
Verified source
PubMedDOI

Content Changes

* **Advantage:** lessLess affected by medial calcification.arterial calcification (MAC).
* **Useful:** diabetes,Patients with diabetes mellitus (DM), the elderly, and dialysis patients.patients, particularly when the ankle-brachial index (ABI) is elevated (>1.40) or non-compressible. [@acc2025-e]
* **Cutoff:** A toe-brachial index (TBI) <0.7 =is diagnostic of peripheral arterial disease (PAD). [@potier2011] [@aboyans2012] [@aha2016] [@acc2025-e]
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