Validation of digital ankle-brachial index as a screening tool in symptomatic patients with peripheral arterial disease

Abstract Introduction There is scarcity of data validating portable digital ankle-brachial index (ABI) with contrast angiography in peripheral arterial disease (PAD). Our aim was to provide an objective analysis of the relationship between digital ABI (dABI) and peripheral angiographic data. Methods Consecutive patients with symptoms of PAD between May 2014 to May 2015 at Einstein Medical Center, Philadelphia, who were undergoing simultaneous dABI and peripheral angiography, were evaluated. Measurements were made using the FloChec™ Digital ABI system (Bard) prior to the scheduled peripheral angiogram. Results The final cohort consisted of 51 patients. Mean age was 68.8 ± 9.5 years with 55% being male. Aorto-iliac disease accounted for 13% of the total lesions, while femoro-popliteal lesions comprised 55%. The FloChec™ digital ABI had a sensitivity of 84% and a positive predictive value of 84%. The area under the receiver operating characteristic curve was 0.74 (p = 0.007). On multivariate analysis, FloChec™ digital ABI was still an independent predictor of PAD, Odds ratio 6.8 (2.3–20.6, p = 0.001). Conclusion A portable, point-of-care digital ABI system can be used as a valuable, simple, cost-effective and reliable screening tool with high sensitivity and accuracy. To date, ours is the first study validating FloChec™ digital ABI with the gold standard angiographic data.