In occidental countries more than 20% of people over 65 years of age have peripheral artery diseases (PAD) however more than 50% of them are asymptomatic and therefore undiagnosed and untreated. According to current guidelines, ankle brachial index (ABI) should be measured in primary care to screen for PAD. This is however not performed in clinical practice because the standard Doppler method to assess ABI is cumbersome and time consuming. In this study we compare ABI measurements obtained by an improved automated oscillometric device, the MESI ABPIMD device (MESI d.o.o., Slovenia) with the standard Doppler method.Design and method:
ABI was measured in a general practice 4 times in random order in each subjects: 2 with Doppler probes by 2 operators (ABI_dop) and 2 with the MESI device (ABI_mesi). ABI_dop was measured from the ratio of the highest systolic blood pressure from both tibial and dorsalis pedis artery by the highest systolic blood pressure of both brachial artery. ABI_mesi was obtained automatically with simultaneous measurements on three extremities by MESI ABPI MD device.Results:
According to ABI_dop, PAD was present in 10% of the 136 screened subjects (68,2 ± 7,4 years). Inter-operator coefficient of variation (CV) was 5,5% for ABI_dop while the intra-subjects CV for ABI_mesi was 3,0%. ABI_mesi was correlated with ABI_dop (R = 0,61, p < 0,0001). The difference between the 2 techniques was normally distributed, centred at 0,06 ± 0,14, with negligible bias across the range (R = 0,19, p < 0,0001). Therefore ABI_mesi provided slightly but significantly higher values than ABI_dop (p < 0,0001). ABI_mesi < 1 had a sensitivity of 85% and specificity of 96% to detect ABI_dop <0,9 and hence PAD. MESI ABPI MD measurements were completed three times faster than Doppler probe measurements.Conclusions:
MESI improved automated oscillometric method offered a faster and repeatable measure of ABI with only a small, clinical irrelevant overestimation of ABI value. The tested MESI ABPI MD improved oscillometric system can be used as screening tool for patients in general practice and would enable family doctors to comply with current guidelines for PAD.