Lewis Jane, Kenkre Joyce

1. “DO ABI AND PULSE VOLUME COMPARE WITH
THE DUPLEX SCAN FOR IDENTIFYING PAD?”
Dr Jane Lewis
Cardiff and Vale University Health Board, UK
Aim
To compare the sensitivity and specificity of an *automated
Ankle-Brachial Index (ABI) and Pulse Volume waveform
(PVR) with the Ultrasound Duplex Scan (UDS) for
identifying Peripheral Arterial Disease (PAD)
EP452

2. Methods
Patients that were referred for
lower limb arterial scans at
two Vascular Laboratory
departments in the UK
underwent an automated ABI
and PVR measurement using
a device utilising Volume
Plethysmography followed by
a UD Scan.
PAD was recorded for
automated ABI if ABI <0.9
(and noted if >1.30), PVR’s if
graded mild/moderate/severe
and with a haemodynamically
significant stenosis or
occlusive disease with the
UDS. A result of PAD or NO
PAD was recorded for each
patient and each method.
The outcome measures for
this study were the sensitivity,
specificity and accuracy
between the automated ABI
and UDS results and the PVR
and UDS results.

3. Results
38% were found to have PAD using
the gold standard UDS
Smoker and PAD = 16.4% yes,
11.7% non, 11.7% ex
CHD had PAD = 15%
Diabetes and PAD = 7%
Overall results were:
ABI and UDS
sensitivity 85%
specificity 89%
overall accuracy 88%
PVR and UDS
sensitivity 97%
specificity 89%
overall accuracy 95%
200 patients recruited
195 completed study
5 sets of results were
rejected due to
equipment failure (n=3)
and patients discomfort
at laying supine (n=2)
65% male, 35% female
Mean age was 67 years
(SD 12.38)
Diabetes = 26.7% with,
73.3% without
CHD = 36.7% with,
63.3% without
Smoking = 28.9% yes,
41.1% non, 30% ex

4. ResultsExamples of normal & mild disease
Examples of moderate and severe disease
A) Both ABI and PVR waveforms indicate normal lower limb arterial supply
C) Both ABI and PVR waveforms indicate moderate PAD
B) Left ABI and PVR waveform indicate normal lower limb arterial supply and right ABI and PVR waveform
indicate mild PAD
D) Left ABI and PVR waveform indicate normal lower limb arterial supply and right ABI and PVR waveform
indicate severe PAD

5. Conclusions
With the potential of raised
ABI’s in those with diabetes
mellitus and chronic kidney
disease (often raised into the
normal range), the combined
use of the ABI and PVR within
one device can only enhance
vascular assessment for
treatment planning of leg
ulcers and foot wounds.
With the results being
clinically acceptable and its
rapid assessment time, the
automated device could also
be introduced into a primary
care screening environment
as a reliable tool for
confirming symptomatic PAD
and early identification of
asymptomatic PAD for those
at risk.
*Dopplex Ability – Huntleigh Healthcare, Cardiff, UK
Acknowledgements: Professor Joyce Kenkre – University of South Wales, UK
Dr Jon Evans – Huntleigh Healthcare, UK