Back to 2025 Display Posters
Toe Brachial Indices Are An Accurate Peripheral Artery Disease Screening Tool In Vascular Deserts
Carolina Aparicio, MD
1, Caitlin W. Hicks, MD MS
2, Clara Gomez-Sanchez, MD
3, Aaron Zaldana, MD
1, Tomas Alamin
3, Leigh Ann O'Banion
1.
1University of California San Francisco, Fresno Campus, Fresno, CA, USA,
2Johns Hopkins University, Baltimore, MD, USA,
3University of California San Francisco, San Francisco, CA, USA.
Objective: Targeted cardiovascular screening in vascular deserts (VD), regions lacking vascular providers, is necessary to address issues of health literacy and poor access to care in high-risk socioeconomically disadvantaged populations. This study aims to evaluate toe brachial indices (TBI) as an accurate way to screen this patient population.
Methods: Patients screened for PAD in VD were combined with 50 retrospective patients seen in the vascular clinic (VC) who underwent ABI/TBI testing. PAD was defined as an ABI <0.9 or TBI <0.7 and non-compressibility (NC) as ABI ≥1.4. ANOVA and correlation analyses were used to assess relationships between ABI and TBI overall and among patients without NC, stratified by diabetes status and claudication symptoms.
Results: 99 patients were screened. Average age was 60±19 years, 38% smokers and 36% previously diagnosed with diabetes or a screened HbA1c >5.7%. PAD was diagnosed in 36%, and 8% were NC. There were significant and graded associations of TBI with ABI: among patients with ABI<0.9, mean TBI was 0.38 (95% CI 0.31, 0.45), compared to 0.90 (95% CI 0.84, 0.96) among patients with .9<ABI<1.4, and 1.33 (95% CI 1.18, 1.48) among patients with ABI≥1.4 (P<0.001). Strong correlation was identified between ABI and TBI (Pearson’s correlation coefficient [PCC] 0.82, P<0.001) overall and in patients with measurable ABI (PCC 0.83, P<0.001), but not among patients with NC ABIs (PCC 0.38, P<0.001). Results were similar when stratified by diabetes and claudication (P<001; Figure).
Conclusion: TBI mirrors ABI and is an efficient and accurate tool to screen at risk patients for PAD, particularly those with DM and non-compressible vessels, and can provide valuable information to providers in vascular deserts.
Back to 2025 Display Posters
