Pressure Indices in Peripheral Arterial Disease Assessed by Infrared Photosensors.

Ankle–brachial index (ABI) assessment by Doppler is operator dependent and limited in calcified arteries. For the detection of peripheral arterial disease (PAD), we evaluated ABI and toe–finger (ToFi) pressures by infrared (IR) sensors at the digits and compared with standard Doppler (Doppler-ABI) in 100 patients with PAD and in 15 controls. Pressure indices were obtained in 86% for Doppler-ABI, 82% for IR-ABI, and 94% for IR-ToFi (P < .01). According to Bland–Altmann analysis, IR-ABI and Doppler-ABI are exchangeable (limits of agreement [loa] −0.30; 0.30, bias −0.003, 95% confidence interval [CI] −0.02; 0.02), whereas IR-ToFi was not (loa −0.23; 0.61, bias of 0.2, 95% CI 0.16; 0.23). The IR-ToFi revealed the best inter- and intrarater agreement (0.92/0.98) followed by IR-ABI (0.74/0.98) and Doppler-ABI (0.66/0.89). Ankle–brachial arterial pressure index can be assessed by IR photosensors. Although toe–finger index is not exchangeable with standard Doppler, it will need further exploration to define its value for the diagnosis of PAD due to its excellent inter- and intrarater agreement. [ABSTRACT FROM PUBLISHER]