Vascular Medicine Unit, Hospital of Cholet, Cholet, Pays de la Loire, France.
Vascular Medicine Department, University Hospital Angers, Angers, Pays de la Loire, France.
Vasc Med. 2024 Apr;29(2):153-162. doi: 10.1177/1358863X231226216. Epub 2024 Mar 12.
Maximal acceleration time of distal arteries of the foot (AT) is correlated to ankle-brachial index (ABI) and toe-brachial index (TBI), and seems very promising in diagnosing severe peripheral artery disease (PAD) and especially critical limb-threatening ischemia (CLTI). Our goal was to confirm the cut-off value of 215 ms to predict a toe pressure (TP) ⩽ 30 mmHg.
A 4-month retrospective study was conducted on patients addressed for suspicion of PAD. Demographic data, ABI, TBI, and Doppler ultrasound scanning parameters of the dorsal pedis and lateral plantar arteries (DPA and LPA) were recorded.
A total of 137 patients with 258 lower limbs were included. AT was highly correlated to TBI ( = -0.89, < 0.001). With the cut-off value of 215 ms, AT was effective to diagnose TP ⩽ 30 mmHg with a sensitivity of 93% [95% CI 77-99], a specificity of 96% [95% CI 92-98], a positive predictive value of 73% [95% CI 56-86], a negative predictive value of 99% [95% CI 97-100], and an area under the receiver operating characteristics curve of 0.99 [95% CI 0.98-1.00]. AT also showed promising results to rule out PAD in healthy patients.
AT is a reliable diagnostic tool to diagnose low TP and could be a new easily performed hemodynamic criterion for diagnosis of CLTI.
足部远端动脉最大加速度时间（AT）与踝臂指数（ABI）和趾臂指数（TBI）相关，在诊断严重外周动脉疾病（PAD），尤其是临界肢体缺血（CLI）方面似乎很有前途。我们的目标是验证 215 毫秒的截断值来预测趾压（TP）≤30mmHg。
对疑似 PAD 的患者进行了为期 4 个月的回顾性研究。记录了人口统计学数据、ABI、TBI 和背侧足弓和外侧足底动脉（DPA 和 LPA）的多普勒超声扫描参数。
共纳入 137 例 258 例下肢患者。AT 与 TBI 高度相关（ = -0.89， < 0.001）。当截断值为 215 毫秒时，AT 能够有效地诊断 TP≤30mmHg，其灵敏度为 93%[95%CI 77-99]，特异性为 96%[95%CI 92-98]，阳性预测值为 73%[95%CI 56-86]，阴性预测值为 99%[95%CI 97-100]，接受者操作特征曲线下面积为 0.99[95%CI 0.98-1.00]。AT 也显示出在健康患者中排除 PAD 的良好结果。
AT 是一种可靠的诊断工具，可用于诊断低 TP，并且可能是一种新的易于实施的血流动力学标准，用于诊断 CLI。
