Pedal Acceleration Time An Alternative Tool To Ankle-Brachial Index In Peripheral Arterial Disease

Authors

  • Eduardo Silva Department of Angiology and Vascular Surgery, Coimbra Hospital and University Centre, Coimbra, Portugal https://orcid.org/0000-0002-5202-9070
  • Joana Iglésias Department of Angiology and Vascular Surgery, Coimbra Hospital and University Centre, Coimbra, Portugal https://orcid.org/0009-0008-2776-4920
  • Pedro Lima Departement de Chirurgie Vasculaire, Polyclinique du Sidobre, Castres, France https://orcid.org/0000-0003-1492-2359
  • Luís F. Antunes Department of Angiology and Vascular Surgery, Coimbra Hospital and University Centre, Coimbra, Portugal https://orcid.org/0000-0001-6237-7354
  • Manuel Fonseca Department of Angiology and Vascular Surgery, Coimbra Hospital and University Centre, Coimbra, Portugal

DOI:

https://doi.org/10.48729/pjctvs.409

Keywords:

Pedal Acceleration Time, Ankle-Brachial Index, Peripheral Arterial Disease, Duplex Ultrasound, Diagnosis

Abstract

Introduction: Ankle-Brachial Index (ABI) is a well-established diagnostic tool for evaluating peripheral arterial disease (PAD). Limitations in its application led to the development of alternative diagnostic methods, including Toe-Brachial Index (TBI) and Transcutaneous Pressure of Oxygen (TcPO2), yet these are not as widely available as ABI. Recently, Pedal Acceleration Time (PAT), has gained popularity as a new tool to assess PAD, requiring only an ultrasound. This study seeks to further establish the correlation between ABI and PAT, determining whether PAT can be a reliable alternative for diagnosing and assessing the severity of PAD.
Methods: ABI and PAT were measured in patients attending our consult with no history of vascular or endovascular surgery. Limbs with unmeasurable ABI were excluded. Patients were categorized into groups based on their PAD stage according to the Fontaine classification. Patient demographics, comorbidities and respective ABI and PAT were analysed.
Results: Sixty-nine patients (114 limbs) were included in the study. Mean age 68 ± 11.7 years, 78.3% male and 33.3% diabetic patients. Fifty-three claudicant limbs (46.5%) and 26 limbs (22.8%) with chronic limb threatening ischemia. Pearson correlation coefficient between ABI and PAT, showed a strong negative correlation (r= -0.78; p<0.01). Mean ABI and PAT for limbs in Fontaine stage I were 0.94 ± 0.17 and 82.0 ± 27.4 ms; Fontaine stage IIa 0.69 ± 0.21 and 141.3 ± 57.8 ms; Fontaine stage IIb 0.54 ± 0.14 and 173.4 ± 65.1 ms; Fontaine stage III 0.43 ± 0.15 and 216 ± 33.2 ms; Fontaine stage IV 0.49 ± 0.17 and 206.7 ± 78.1 ms, respectively.
Conclusion: Our study suggests an inverse correlation between ABI and PAT, in accordance with the findings published in the literature, thus supporting the use of PAT as an easily reproducible and efficient alternative to ABI for evaluating the severity of PAD.

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References

Criqui MH, Matsushita K, Aboyans V, Hess CN, Hicks CW, et al. Lower Extremity Peripheral Artery Disease: Contemporary Epidemiology, Management Gaps, and Future Directions: A Scientific Statement from the American Heart Association. Circulation. 2021;144:e171-e191. doi:10.1161/CIR.0000000000001005.

Sommerset J, Karmy-Jones R, Dally M, Feliciano B, Vea Y, et al. Plantar Acceleration Time: A Novel Technique to Evaluate Arterial Flow to the Foot. Ann Vasc Surg. 2019;60:308-314. doi:10.1016/j. avsg.2019.03.002.

Sommerset J, Teso D, Feliciano B, Vea Y, Sentman M, et al. Innovative Arterial Duplex Examination: A Guide to Evaluate Flow in the Foot Using Pedal Acceleration Time. J Vasc Ultrasound. 2019;43:11-17. doi:10.1177/1544316719827328.

Teso D, Sommerset J, Dally M, Feliciano B, Vea Y, et al. Pedal Acceleration Time (PAT): A Novel Predictor of Limb Salvage. Ann Vasc Surg. 2021;75:189-193. doi:10.1016/j.avsg.2021.02.038.

Sommerset J, Feliciano B, Karmy-Jones R, Vea Y, Dally M, et al. Duplex Ultrasound Defined Angiosome with the use of Pedal Acceleration Time as a Predictor to Wound Healing. J Vasc Surg. 2020;72:e213. doi:10.1016/j.jvs.2020.04.360.

Trihan JE, Mahé G, Croquette M, Coutant V, Thollot C, et al. Accuracy of Acceleration Time of Distal Arteries to Diagnose Severe Peripheral Arterial Disease. Front Cardiovasc Med.

Fontaine R, Kim M, Kieny R. Surgical treatment of peripheral circulation disorders [in German]. Helv Chir Acta 1954;21: 499–533. 8. Conte MS, Bradbury AW, Kolh P, White JV, Dick F, et al. Global Vascular Guidelines on the Management of Chronic Limb-Threatening Ischemia [published correction appears in Eur J Vasc Endovasc Surg. 2020 Mar;59(3):492-493] [published correction appears in Eur J Vasc Endovasc Surg. 2020 Jul;60(1):158-159]. Eur J Vasc Endovasc Surg. 2019;58:S1-S109.e33. doi:10.1016/j.ejvs.2019.05.006

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Published

13-05-2024

How to Cite

1.
Silva E, Iglésias J, Lima P, F. Antunes L, Fonseca M. Pedal Acceleration Time An Alternative Tool To Ankle-Brachial Index In Peripheral Arterial Disease. Rev Port Cir Cardiotorac Vasc [Internet]. 2024 May 13 [cited 2024 May 21];31(1):29-32. Available from: https://pjctvs.com/index.php/journal/article/view/409

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