Peripheral arterial disease is a major symptom of atherosclerosis or fat accumulation in the blood vessels throughout the entire circulation system. On average, it is present in about 12% of the population in each age group, and regardless of whether people with peripheral arterial disease have history of symptoms related to coronary artery disease or thrombotic stroke, they equally have greater risk of death from cardiovascular disease.
Did you know that the higher levels of low-density lipid (LPL) you have, the greater risk you have of peripheral arterial disease? Lipid levels can be classified according to the following ranges:
- Less than 100 mg./dl. means a good level.
- 100 – 130 mg./dl. means a fair level.
- 130 – 160 mg./dl. means a medium level.
- 160 – 190 mg./dl. means a high level.
- More than 190 mg./dl. means a very high level.
Basis for Risk Assessment of Peripheral Arterial Disease
The risk of peripheral arterial disease increases in step. It can be assessed from sex and age. Men older than 40 years and women older than 50 years and menopausal women have increasing levels of risk from cholesterol accumulation. However, their risk for peripheral arterial disease is exponentially increased if they are also diagnosed with other diseases such as diabetes or vascular diseases such as stroke, carotid artery disease, abdominal arterial disease or peripheral arterial disease in the legs. These conditions enable a clearer determination of the risk level for peripheral arterial disease.
Screening for Vascular Risks Throughout the Body
Screening for vascular risks throughout the entire body is a way to preliminarily diagnose peripheral vascular disease (PVD) caused by obstruction in the blood vessels in the legs. It can be performed by measuring the ankle brachial pressure indices (ABI) and then making comparisons on each side in order to determine whether there is any stenosis or blockage of the blood vessels concerned.
What can ABI screening do?
- It provides a view into arterial obstructions as well as vascular elasticity.
- It helps diagnose or identify early-stage peripheral artery disease due to stenosis in the legs that often occurs along with heart and brain blood vessel obstructions.
- It can help predict future risk of cardiovascular disease.
- It can be used to assess the severity of blood vessel stenosis.
- It can be used to assess treatment outcomes.
Interpreting ABI Results
The pressure value of normal arteries should be greater than or equal to 1.0. If the pressure value is less than 0.9, there might be a blockage problem, and the doctor will consider the presence of risk indications for a vascular disease. Additional diagnostics may be necessary, including CT scan or MRI scan after injecting a contrast medium into the blood vessels. In 95% of cases, peripheral arterial disease will be found.
Test Procedure
- The person undergoing the test must lie flat with arms and legs level with the heart.
- The person should lie down in the most comfortable position and not talk, touch the cuffs or move the arms and legs during the test, otherwise inaccurate values may result or more time might be required to take measurements than necessary, since repeat measurements will have to be performed.
- The technician will immediately stop the device if the person receiving the test experiences any pain or abnormality during the measurement.
- Patients with metal braces in their arms or legs cannot receive this test.
Measuring arterial pressure can facilitate the classification of the severity of the disease. It is commonly found that patients with chronic symptoms or arm or leg weakness with significant pain during physical exercise have pressure index values from 0.5 to 0.8. In these cases, the patient should consult a vascular doctor for additional diagnosis and treatment. Meanwhile, in patients with very severe symptoms to the point that the peripheral tissues of the legs have suffer from ischemia and necrosis, they often have an arterial pressure index of 0.5 or less. These are urgent cases that require immediate medical attention.
