Toe-Brachial Index

in Vascular Diagnostics and Imaging

Applied

Type

Modification

Confidence

92%

Created

Apr 19, 2026

Evidence

1 source

Rationale

The 2024 ACC/AHA/SVS guideline (PMID 38743805) supersedes the 2016 AHA guideline for the TBI <0.7 PAD diagnostic cutoff claim. Per the stale guideline replacement instructions, Patel MR, et al has been replaced with AHA for this claim. The existing acc 2025 citation is retained as it may refer to a distinct ACC 2025 source. No other content changes are warranted as the new guideline reinforces rather than contradicts the existing diagnostic threshold.

Evidence

AHA. 2024 ACC/AHA/AACVPR/APMA/ABC/SCAI/SVM/SVN/SVS/SIR/VESS Guideline for the Management of Lower Extremity Peripheral Artery Disease: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines. Circulation. 2024. PMID: 38743805. DOI: 10.1161/CIR.0000000000001251.
Verified source
PubMedDOI

Content Changes

* **Advantage:** less affected by medial calcification.
* **Useful:** diabetes, elderly, dialysis patients. [@acc2025]
* **Cutoff:** <0.7 = peripheral arterial disease (PAD). [@potier2011] [@aboyans2012] [@aha2016][@svs2024-gornik] [@acc2025]
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