Non-invasive testing

in Atherosclerosis and Risk Factors

Applied

Type

Modification

Confidence

92%

Created

Apr 26, 2026

Evidence

1 source

Rationale

The stale citation acc 2025 c was replaced with the superseding 2026 ACC/AHA guideline ACC/AHA for the same claim about non-compressible ABI values and the importance of TBI in diabetic patients. The existing citation key acc2026 already exists in the chapter and refers to this PMID, so no new key was created. No other content changes were warranted as the article is a guideline update rather than new clinical evidence requiring substantive text revision.

Evidence

ACC/AHA. Management of Lower Extremity Peripheral Artery Disease: Guidelines From the ACC/AHA. 2026. PMID: 41252847.
Verified source
PubMedDOI

Content Changes

Non-invasive hemodynamic tests—including ankle-brachial index (ABI), toe-brachial index (TBI), transcutaneous oximetry (TcPO₂), and skin perfusion pressure (SPP)—are essential for peripheral arterial disease (PAD) diagnosis, severity stratification, and wound-healing prediction. These tests represent the high-value, first-line diagnostic approach, helping to avoid the misallocation of more expensive advanced imaging resources [@raskin2025-narrative]. In patients with diabetes, where medial arterial calcification (MAC) may lead to falsely elevated or non-compressible ABI values, TBI and other physiological assessments are particularly critical for accurate assessment [@acc2025-c].[@acc2026-f].

For measurement techniques, see [[Diagnostics in Vascular Surgery|Ch. 3]]. For chronic limb-threatening ischemia (CLTI) thresholds and Wound, Ischemia, and foot Infection (WIfI) integration, see [[Peripheral Artery Disease|Ch. 10]].
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