Author Block D Armstrong, D Brouillard, U Jurt, M Matangi
BACKGROUND: To determine the prevalence of absent peripheral foot pulses in patients with normal ankle brachial indexes (ABI) and toe brachial indexes bilaterally.
METHODS: Our cardiology database was searched for all patients who underwent PAD testing. We included patients where all 4 ABIs were in the range of 0.90-1.30 and the toe-brachial index being ≥0.70. Duplicate studies were removed. The peripheral pulse examination is performed by a Nurse who has performed 3,342 PAD studies. Pulses are recorded as absent (0/3), reduced (1/3), normal (2/3) or increased (3/3). Of the 3,342 studies, 2,965 had all 4 ABIs recorded and of these, 1,706 had all normal ABIs. Of the 1,706, 1,388 had all 4 ABIs and both TBIs being normal. Once duplicate studies were removed 1,338 remained and make up the study population.
RESULTS: There were 879 males and 459 females with a mean age of 64.2±10.7. The mean right ABI was 1.15±0.08 and TBI 0.92±0.14. The mean left ABI was 1.14±0.08 and TBI 0.92±0.14. 387 patients had at least one absent foot pulse, (28.9%). The main results are seen in the table below.
|DP = Dorsalis pedis. PT = Posterior tibial. R) = Right. L) = Left.
CONCLUSION: An absent peripheral foot pulse in a patient without PAD is common, (28.9%). Overall approximately 15% had an absent dorsalis pedis pulse and 9% an absent posterior tibial pulse. Both dorsalis pedis pulses were absent in 10.4% and both posterior tibial pulses in 6.1%. In a small percentage all foot pulses were absent, (1.3%).