7
Table 6. Physiological Testing
COR LOE
Recommendations
I B-NR TBI should be measured to diagnose patients with suspected
PAD when the ABI is >1.40.
I B-NR Patients with exertional non–joint-related leg symptoms and
normal or borderline resting ABI (>0.90 and ≤1.40) should
undergo exercise treadmill ABI testing to evaluate for PAD.
IIa B-NR In patients with PAD and an abnormal resting ABI (≤0.90),
exercise treadmill ABI testing can be useful to objectively assess
functional status.
IIa B-NR In patients with normal (1.00–1.40) or borderline (0.91–0.99)
ABI in the setting of non-healing wounds or gangrene, it is
reasonable to diagnose CLI by using TBI with waveforms,
TcPO
2
, or SPP.
IIa B-NR In patients with PAD with an abnormal ABI (≤0.90) or with
noncompressible arteries (ABI >1.40 and TBI ≤0.70) in the
setting of nonhealing wounds or gangrene, TBI with waveforms,
TcPO
2
, or SPP can be useful to evaluate local perfusion.
Table 5. Resting ABI for Diagnosing PAD
COR LOE
Recommendations
I B-NR In patients with history or physical examination findings
suggestive of PAD (Table 3), the resting ABI, with or without
segmental pressures and waveforms, is recommended to establish
the diagnosis.
I C-LD Resting ABI results should be reported as abnormal (ABI
≤0.90), borderline (ABI 0.91–0.99), normal (1.00–1.40), or
noncompressible (ABI >1.40).
IIa B-NR In patients at increased risk of PAD (Table 2) but without history
or physical examination findings suggestive of PAD (Table 3),
measurement of the resting ABI is reasonable.
III: No
Benefit
B-NR In patients not at increased risk of PAD (Table 2) and without
history or physical examination findings suggestive of PAD
(Table 3), the ABI is NOT recommended.
