Pulsatility index is better than ankle-brachial Doppler index for non-invasive detection of critical limb ischaemia in diabetes

Abstract

The pulsatility index is a better noninvasive technique than the ankle-brachial Doppler index or the systolic ankle pressure to assess critical limb ischaemia in diabetic polyneuropathy. A pulsatility index < 1.2 at the ankle arteries is a reliable criterion for diagnosis of CLI in diabetic patients with polyneuropathy.

Pattern of Vascular Insufficiency on Ultrasound Colour Doppler and Computed Tomographic Angiography in Patients with Diabetic Foot and Its Clinical Outcome

“…The earliest signs (grey scale) of atherosclerotic disease are thickening of intima and media followed by wall changes (luminal narrowing and soft or hard plaques) and turbulence & flow irregularities on color Doppler flow images [16]. In our study, plaque variants intimal thickening and atheroma were more common in popliteal (18.21% and 17.29% respectively) and superficial femoral arteries (17.68% and 17.29% respectively).…”

“…Leoniuk et al found that lower values of pulsatility index were significantly more common in the subgroup of patients with trophic skin changes [12]. Janssen et al demon strated that the pulsatility index is a better marker in non --invasive assessment of critical limb ischemia in diabetic patients with polyneuropathy than the ankle-brachial index [16].…”

The ultrasonographic evaluation of hemodynamic changes in patients with diabetic polyneuropathy after tarsal tunnel decompression

“…In the literature, Doppler ultrasound flow imaging is the most common method for evaluating the arteries of lower extremities . Janssen et al declared that PI is the best method for the evaluation of critical limb ischemia in patients with diabetic polyneuropathy . All Doppler USG measurements were performed as routine distal lower extremity arterial examination over certain predefined anatomical points.…”

“…19 Janssen et al declared that PI is the best method for the evaluation of critical limb ischemia in patients with diabetic polyneuropathy. 24 All Doppler USG measurements were performed as routine distal lower extremity arterial examination over certain predefined anatomical points. For posterior tibial artery the midpoint between medial malleolus and Achilles tendon and for the dorsalis pedis artery the point on the midline of 1 st web, 4 cm proximal to the 1 st MTP joint was used with a standardized leg position and room temperature for all patients.…”

Doppler Ultrasound Detection of Preclinical Changes in Foot Arteries in Early Stage of Type 2 Diabetes

“…In the assessment of flow parameters (PSV, EDV, RI, PI) significant correlations were observed for the pulsatility index – lower values were significantly more common in the subgroup of patients with trophic skin changes. Janssen et al demonstrated that the pulsatility index is a better marker in noninvasive assessment of limb ischemia in diabetic patients that the ankle-brachial index [16]. …”