Measuring
Position patient supine
Measure SBP from both brachial<unk> es using cuff and handheld Doppler over the AC fossa
Measure SBP from both DP and PT<unk> es using cuff placed just proximal to the malleoli with Doppler over<unk>  (5-8% of normal patients have absent DP pulse)
Calculate ABI on each leg by taking the highest ankle SBP divided by the highest brachial SBP and record to 2 decimal places
Using calculation
0.91–1.30: normal
0.70–0.90: mild occlusion
0.40–0.69: moderate occlusion
<0.40: severe occlusion
>1.30: poorly compressible/calcified vessels
0.91–1.30: normal
0.70–0.90: mild occlusion
0.40–0.69: moderate occlusion
<0.40: severe occlusion
>1.30: poorly compressible/calcified vessels
Xray
Little use or benefit
Ultrasound
Accurate for detecting obstruction in femoral/popliteal/bypass grafts
Sn declines at/below the calf
Quality of signal (triphasic, biphasic, monophasic) is important to note
CTA
Sensitivity similar to that of conventional angiography
MRI
Limited utility in the ED setting
Detailed images of vasculature can be taken and plaques identified
Little use or benefit
Accurate for detecting obstruction in femoral/popliteal/bypass grafts
Sn declines at/below the calf
Quality of signal (triphasic, biphasic, monophasic) is important to note
Sn declines at/below the calf
Sensitivity similar to that of conventional angiography
Limited utility in the ED setting
Detailed images of vasculature can be taken and plaques identified
Peripheral artery disease
Phlegmasia Alba Dolens
Raynaud’s disease
Phlegmasia Cerulea Colens
Decubitus ulcers
Ankle fracture
Carotid stenosis
Venous thromboembolism