Relying on an ABI index to diagnose PAD will cause you to miss or misdiagnose many patients. Better to use skin perfusion, PVRs, or TcPO2 if available. If not, then use your own ears and listen to the pulse volume with a good Doppler. You can readily discern between a monophasic, biphasic, or triphasic pulse wave. While practicing, I referred at least 150 patients to interventional cardiology and vascular surgeons for revascularization that previously had been totally misdiagnosed and untreated. Any decent Doppler that produces a good waveform coupled with a good ear can easily save many legs.
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