Diagnosing Peripheral Artery Disease
If history or exam are suggestive of PAD, or risk factors are present, an Ankle Brachial Index (ABI) can indicate whether further assessment is necessary.
ABI = 1.0-1.39: Look for other causes of symptoms/abnormal exam
ABI = 0.91-0.99: Possible PAD. Obtain exercise treadmill ABI or 6 MWT*
ABI <0.90: GDMT* if CLI* not present
ABI >1.40: Obtain Toe Brachial Index (TBI). TBI <0.70 indicates PAD.
If CLI suspected and ABI non-compressible, obtain TBI with waveforms or toe perfusion pressure
*6 MWT: 6 minute walk test
GDMT: Guideline directed medical therapy
CLI: Critical leg ischemia
Where to Refer for Diagnostic Testing
All Mount Sinai Locations: ABI Testing, Exercise ABI, Toe Brachial Index (with waveforms), Toe Perfusion Pressure
Mount Sinai West and Mount Sinai Downtown Only: Transcutaneous 02 pressure
