Effect of ankle brachial index examination on central aortic blood pressure in patients with peripheral artery disease

Background: Ankle brachial index (ABI) measurements are useful for detecting peripheral artery disease (PAD) as a screening test. In general, ABI examinations are contraindicated in patients with aortic aneurysm and history of aortic aneurysm. However, little is known whether ABI examinations elevate central aortic blood pressure (CBP). Method: From June 2018 to August 2020, we prospectively analyzed 66 patients who were performed cardiac catheterization through femoral approach and divided into peripheral artery disease complicated (PAD, N = 27) and uncomplicated (non-PAD, N = 39) groups. After insertion of pigtail catheter into both ascending (Asc), abdominal (Abd) positions, resting CBPs at Asc and Abd were measured. Subsequently, we measured each CBP during ABI, respectively. We compared resting CBP (R-CBP) and CBP during ABI (ABI-CBP) between PAD and non-PAD groups. Results: In non-PAD group, ABI-CBP at Abd was significantly higher than BL-CBP (P < 0.05). On the other hand, there were no significant ABI-CBP elevation at Asc and Abd in PAD. There was no case with CBP elevation more than 20mmHg during ABI measurements in both groups. Furthermore, no clinical events were observed after ABI measurements in both groups. Conclusion: ABI was considered a safe testing in patients with suspected PAD.