A substudy of the IN.PACT DEEP trial shows that the ankle-brachial index identifies CLI in only 6 percent of affected patients. The researchers say guideline revisions and better diagnostic tools are needed.
Source: To Diagnose Critical Limb Ischemia, Look to the Toe as Well as the Ankle – Consult QD
Of course. Pedal skin perfusion and therefore pedal angiosome perfusion need more local direct measurement than the indirect and distant (normalized) ankle/arm index. Measurement of true pedal perfusion must take into account the true arterial architecture (and its potential pathology) found in the pedal angiosome.