Peripheral artery disease (PAD) is a widespread but often underdiagnosed condition affecting millions worldwide. Traditional diagnostic tools like the ankle-brachial index (ABI) and toe-brachial index (TBI) have limitations, particularly in patients with diabetes or medial arterial calcification. A newly published study in the European Journal of Vascular & Endovascular Surgery by Sommerset et al. introduces pedal acceleration time (PAT) as a promising adjunctive test for PAD assessment.
Key Findings of the Study
The study, conducted across four international centers, assessed the diagnostic accuracy of PAT in 188 participants (227 limbs) with suspected PAD. Key findings include:
- PAT demonstrated moderate overall accuracy for PAD detection, with an area under the curve (AUC) of 0.79 (95% CI 0.74 – 0.85)—comparable to ABI and TBI.
- PAT significantly correlated with toe systolic pressures and TBI, making it a viable alternative for patients with missing toes, open wounds, or unreliable ABI readings.
- A diagnostic threshold of >85 ms for PATÂ yielded the highest accuracy, suggesting its utility as a standardized cutoff value.
- The worst-case PAT measure (highest or zero value) provided the most reliable diagnostic performance.
- Intertester reliability was excellent, reinforcing the reproducibility of PAT measurements across different settings.
Why This Matters
Identifying PAD early is crucial in preventing severe complications, including limb loss. The findings by Sommerset et al. suggest that PAT could serve as an essential tool in vascular assessments, particularly in populations where ABI and TBI have known limitations. The study underscores the potential for PAT integration into clinical workflows, providing a non-invasive, accurate, and accessible means of detecting PAD.
Full Citation & Link to Manuscript
Sommerset J, Teso D, Mills Sr JL, Sebastian M, Kayssi A, Leask S, Rounsley R, Tehan PE, “Diagnostic Test Accuracy of Pedal Acceleration Time to Identify Peripheral Artery Disease,” European Journal of Vascular & Endovascular Surgery(2025). DOI: https://doi.org/10.1016/j.ejvs.2025.03.007.
With growing interest in innovative vascular diagnostics, PAT is a promising addition to the clinician’s toolkit. This study brings us one step closer to better, earlier detection of PAD—leading to improved patient outcomes.
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