A 62-year-old diabetic man with claudication undergoes lower limb arterial Doppler. The ankle systolic pressure exceeds the brachial pressure, giving an ankle-brachial index of 1.45. What is the correct interpretation?
- A Critically reduced perfusion due to distal calcified, incompressible arteries ✓
- B Mild peripheral arterial disease
- C Normal arterial supply, symptoms are non-vascular
- D Acute limb ischaemia
Correct answer: A. Critically reduced perfusion due to distal calcified, incompressible arteries
Explanation
An ABI above 1.4 indicates medial arterial calcification, common in diabetes and chronic kidney disease. The calcified tibial vessels cannot be compressed by the cuff, so measured pressure is falsely high and the true perfusion may be severely impaired. Toe-brachial index or pulse volume recording is then used. Option C is wrong because a high ABI never certifies normal flow, and option B corresponds to ABI between 0.71 and 0.90.
Reference: Rumack's Diagnostic Ultrasound, 6th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.