Sensitivity and Specificity of Ankle Brachial Index (ABI) and Pulse Wave Handheld Doppler (PWHD) Compared with Angiography as Diagnostic Test for Patients with Peripheral Artery Disease (PAD)
-
Published:2021-01-21
Issue:1
Volume:2
Page:10-11
-
ISSN:2715-1239
-
Container-title:Journal of Indonesian Society for Vascular and Endovascular Surgery
-
language:en
-
Short-container-title:JINASVS
Author:
Thomas Valdy1, Tjandra Djony2, Sumangkut Richard2, Karundeng Billy2, Korompis Grace3
Affiliation:
1. General Surgery Resident, Department of Surgery, Faculty of Medicine, University of Sam Ratulangi, Manado, Indonesia 2. Department of Vascular Surgery, Faculty of Medicine, University of Sam Ratulangi, Manado, Indonesia 3. Department of Public Health Sciences, Faculty of Medicine, University of Sam Ratulangi, Manado, Indonesia
Abstract
Background: Peripheral artery disease (PAD) is a clinical condition that occurs due to atherosclerosis and narrowing of the arteries involving the aorta, branches of the visceral arteries such as the iliac arteries, and the arteries of the distal extremities. The femoropopliteal artery is the most commonly involved site in patients with atherosclerotic PAD. Ankle Brachial Index (ABI) determination may have limited value in some patients with diabetes, because calcification of the tibial artery can render it uncompressible, resulting in a very high ABI value (>1.40). Handheld vascular Doppler with pulse volume waveform interpretation (PVW) is an easily available and non-invasive modality for evaluation of the inferior extremity arteries and can detect the severity of blood flow disturbances or ongoing PAD. The best diagnostic method for PAD is angiography using digital substraction angiography (DSA) to assess existing atherosclerotic lesions. The advantages of ABI and PWHD examinations are in terms of simplicity, ease of use, and non-invasiveness instead of angiography in PAD diagnosis led the investigators to compare the sensitivity and specificity values between ABI and PWHD with angiography as a diagnostic test for PAD patients.
Methods: This study used a cross-sectional diagnostic test design with the subjects were patients diagnosed with PAD, both outpatients and inpatients at Prof. DR. R.D Kandou Manado. ABI, PWHD and angiography examination were performed on all study subjects.
Results: The data show that ABI has a sensitivity of 95.2% and a specificity of 80% in diagnosing PAD patients when compared to angiography as the standard of diagnosis of PAD. PWHD compared to angiography has a sensitivity of 100% and a specificity of 100%. When ABI and PWHD are combined, it has a sensitivity of 100% with a specificity of 80%. The sensitivity and specificity of PWHD compared to angiography based on angiographic location in popliteal artery has a sensitivity of 91.7% and a specificity of 92.6%. PWHD compared with angiography on posterior tibial artery (PTA) has a sensitivity of 81% and a specificity of 88.9%. ABI compared with angiography on dorsalis pedis artery has a sensitivity of 100% and a specificity of 71.4%, with p <0.0001.
Conclusion: The high sensitivity and specificity of ABI and PWHD can be used as a diagnostic test tool for PAD patients by general practitioners in first level health facilities.
Publisher
The Indonesian Society for Vascular and Endovascular Surgery - INASVS
Reference62 articles.
1. 1. Katsanos, K., Tepe, G., Tsetis, D., Fanelli, F. Standards of Practice for Superficial Femoral and Popliteal Artery Angioplasty and Stenting. Cardiovasc Intervent Radiol 2014;37:592-603 2. 2. Nead, KT., Cooke, JP., Olin, JW., Leeper, NJ. Alternative Ankle-Brachial Index Method Identifies Additional At-Risk Individuals. J Am Coll Cardiol 2013;62:553-9 3. 3. Fowkes, FG., Aboyans, V., Fowkes, FJ., McDermott, MM., Sampson, UK., Criqui, MH. Peripheral Artery Disease: Epidemiology and Global Perspectives. Macmillan Publishers 2016 4. 4. Sampson, U., Fowkes, F., McDermott, M., et al. Global and Regional Burden of Death and Disability from Peripheral Artery Disease: 21 World Regions 1990-2010. Glob Heart 2014;9:145-58.e21 5. 5. Purnayoga, B. Hubungan antara Indeks Massa Tubuh dengan Penyakit Arteri Perifer di Posyandu Lansia Nusa Indah Desa Pabelan Kartasura. Universitas Muhammadiyah Surakarta 2018
|
|