Ankle-brachial index:: an essential component for the screening, diagnosis and management of peripheral arterial disease

The measurement of the ankle-brachial index (ABI) or the ankle/arm ratio provides a simple, rapid and cheap method for the evaluation of the distal perfusion of lower limbs. A decreased value underlines an altered arterial state. Thus, ABI is an excellent marker of peripheral arterial disease, even prior to the occurrence of functional symptoms. Beyond the diagnosis of peripheral arterial disease, ABI is nowadays known as a marker of atherosclerosis and a cardiovascular marker. Hence, ABI appears not only as a tool in the functional assessment of lower limbs perfusion, but also a local and general marker of atherosclerosis and cardiovascular events. The aim of this paper is to update data on the usefulness of ABI through a general review, and to present open issues. After a focus on the methodology of ABI measurement, the diagnostic value of ABI will be presented in this paper.