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Table 1 Summary of guidelines for the measurement of the Ankle Brachial Index

From: Current utility of the ankle-brachial index (ABI) in general practice: implications for its use in cardiovascular disease screening

  Rest period Equipment for measurement of brachial systolic pressure Number of brachial pulses to be assessed Equipment for measurement of ankle systolic pressure Ankle pulses which should be assessed Method of calculation of the ABI
American College of Cardiology/American Heart Association (ACC/AHA) 2005 Rest supine for 10 minutes Handheld Doppler ultrasound device & sphygmomanometer 2 Handheld Doppler ultrasound device & sphygmomanometer Dorsalis Pedis artery and Posterior Tibial artery. Higher ankle systolic pressure (for that leg) divided by higher brachial pressure of the two arms.
Scottish Intercollegiate Guidelines Network (SIGN) 2006 Not mentioned Handheld Doppler ultrasound device & sphygmomanometer 2 Handheld Doppler ultrasound device & sphygmomanometer Dorsalis Pedis artery/ Anterior Tibial artery & Posterior Tibial artery. If these cannot be located, assess the Peroneal Artery Higher ankle systolic pressure (for that leg) divided by higher brachial pressure of the two arms.
Trans-Atlantic Intersociety Consensus (TASC) 2007 Not mentioned Doppler Instrument & sphygmomanometer 2 Doppler Instrument & sphygmomanometer Dorsalis Pedis artery & Posterior Tibial artery. Divide both ankle pressures by higher brachial pressures.
Society for Vascular Technology of Great Britain and Ireland (SVT) 2010 Rest supine for 5-10 minutes prior to procedure Handheld continuous wave Doppler ultrasound device & sphygmomanometer 2 Handheld continuous wave Doppler ultrasound device & sphygmomanometer Dorsalis Pedis artery & Posterior Tibial artery. Higher ankle systolic pressure (for that leg) divided by higher brachial pressure of the two arms.
European Society of Cardiology (ESC) 2011 Not mentioned Handheld Doppler ultrasound device & sphygmomanometer 2 Handheld Doppler ultrasound device & sphygmomanometer Posterior Tibial artery & Anterior Tibial artery. Higher ankle systolic pressure (for that leg) divided by higher brachial pressure of the two arms.
National Institute for Clinical Excellence (NICE) 2012 Rest supine when possible. Rest period should be “long enough for blood pressure to return to normal” Handheld Doppler ultrasound device & sphygmomanometer 2 Handheld Doppler ultrasound device & sphygmomanometer Three arteries, one of which must be the Peroneal artery as this “may be the only one present in some people, particularly those with diabetes”. Higher ankle systolic pressure (for that leg) divided by higher brachial pressure of the two arms.
American Heart Association (AHA)–scientific statement 2012 Rest 5-10 minutes in supine position Handheld Doppler ultrasound device & sphygmomanometer 2 Handheld Doppler ultrasound device & sphygmomanometer Dorsalis Pedis artery & Posterior Tibial artery. Higher ankle systolic pressure (for that leg) divided by higher brachial pressure of the two arms.