Toe-Brachial Index

Rationale

The 2025 ACC Scientific Statement provides updated, high-level guidance on the management of PAD in patients with diabetes. It specifically emphasizes the importance of TBI in populations where medial calcification makes ABI unreliable. The integration reinforces existing diagnostic thresholds while updating the evidence base to the most current standards and ensuring all medical abbreviations are properly expanded on first use.

Evidence

Content Changes

* **Advantage:** less affected by medial calcification.
* **Useful:** diabetes,diabetes mellitus, elderly, and dialysis patients.patients, particularly when the ankle-brachial index (ABI) is unreliable. [@acc2025-g]
* **Cutoff:** toe-brachial index (TBI) <0.7 = peripheral arterial disease (PAD). [@potier2011] [@aboyans2012] [@aha2016] [@acc2025-g]