April 2022 Tip of the Month

Diagnosing Peripheral Artery Disease

If history or exam are suggestive of PAD, or risk factors are present, an Ankle Brachial Index (ABI) can indicate whether further assessment is necessary.

ABI = 1.0-1.39: Look for other causes of symptoms/abnormal exam

ABI = 0.91-0.99: Possible PAD. Obtain exercise treadmill ABI or 6 MWT*

ABI <0.90: GDMT* if CLI* not present

ABI >1.40: Obtain Toe Brachial Index (TBI). TBI <0.70 indicates PAD.

If CLI suspected and ABI non-compressible, obtain TBI with waveforms or toe perfusion pressure

*6 MWT: 6 minute walk test

GDMT: Guideline directed medical therapy

CLI: Critical leg ischemia

Where to Refer for Diagnostic Testing

All Mount Sinai Locations: ABI Testing, Exercise ABI, Toe Brachial Index (with waveforms), Toe Perfusion Pressure

Mount Sinai West and Mount Sinai Downtown Only: Transcutaneous 02 pressure

Click here to view referral information

Click here to view the PAD Diagnostic Algorithm

Download the Mount Sinai PAD Quick Reference Guide

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