Is a "spot check" of the ankle Doppler waveform comparable to ABPI?
Research type
Research Study
Full title
Quantitative and qualitative analysis of the ankle Doppler waveform in patients being investigated for peripheral arterial disease (PAD): Is a "spot check" of the ankle waveform comparable to an ankle brachial pressure index (ABPI)? A retrospective pilot study.
IRAS ID
194609
Contact name
Patrick Coughlin
Contact email
Sponsor organisation
Cambridge University Hospitals
Duration of Study in the UK
1 years, 0 months, 0 days
Research summary
Peripheral arterial disease (PAD) occurs when narrowing or blockages in the arteries supplying the legs results in a restriction of blood flow. It is associated with significant morbidity and mortality, and therefore early diagnosis is imperative.
The ankle brachial pressure index (ABPI) is a well-established non-invasive test used to diagnose and grade PAD. NICE guidance recommends that all patients with suspected PAD should have an ABPI as a first line diagnostic test. It is also advised prior to applying compression therapy for venous disease, as if PAD is present, compression can compromise the arterial supply.However, the limitations of ABPI are well documented, particularly in diabetic patients who are susceptible to calcification of the arteries. This results in falsely elevated pressure measurements at the ankle and non-diagnostic results. The ABPI is also user dependent and can be time consuming.
Despite the limitations of ABPIs being well documented, there is limited research on alternate frequently used tests that can be used to diagnose PAD. These include qualitative and quantitative waveform analysis.
Studies have shown qualitative waveform analysis to be a better predictor of PAD than ABPI in diabetic and non - diabetic patients. However, there is limited research on quantitative analysis of the waveform at the ankle and although studies have suggested a correlation between systolic rise time, peak systolic velocities and ABPI, the data was collected over 10 years ago and there have been large advances in equipment in that time.
This pioneering study aspires to bring physiological measurement analysis into the 21st century, using modern ultrasound equipment. The aim is to compare the accuracy of Doppler waveform analysis at the ankle to the ABPI in order to determine their effectiveness at diagnosing PAD.
REC name
London - City & East Research Ethics Committee
REC reference
16/LO/0233
Date of REC Opinion
8 Feb 2016
REC opinion
Further Information Favourable Opinion