ArticleJACC. Cardiovascular interventions2017
Heterogeneity of Ankle-Brachial Indices in Patients Undergoing Revascularization for Critical Limb Ischemia.
Article in JACC. Cardiovascular interventions, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 20 papers, 2 of them syntheses that pooled it.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
20 citing papers in PubMed, 2 syntheses or guidelines pooled it, 43 citations in OpenAlex.
- 2024 ACC/AHA/AACVPR/APMA/ABC/SCAI/SVM/SVN/SVS/SIR/VESS Guideline for the Management of Lower Extremity Peripheral Artery Disease: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines.Journal of the American College of Cardiology · 2024Guideline
- Guideline
- Efficacy and Safety of Sarpogrelate on Symptom Improvement in Patients with Peripheral Arterial Disease (PAD) and/or Being at Risk of PAD: A Single Arm, Multi-Centered, Open-Label Trial.Current vascular pharmacology · 2025Trial
- Establishing Thresholds for Minimal Clinically Important Differences for the Peripheral Artery Disease Questionnaire.Circulation. Cardiovascular quality and outcomes · 2021Trial
- Implications of Modest Reductions in ABI Measurements for Risk of Major Adverse Limb Events Among 223,350 Veterans.Journal of the American College of Cardiology · 2026Article
- Clinical Characteristics and Angioplasty Outcomes in Lower Extremity Artery Disease Patients with Normal Ankle-Brachial Index: A Clinical Conundrum.Acta Cardiologica Sinica · 2025Article
- Standardization and clinical applications of retinal imaging biomarkers for cardiovascular disease: a Roadmap from an NHLBI workshop.Nature reviews. Cardiology · 2025Review
- Skeletal muscle regeneration failure in ischemic-damaged limbs is associated with pro-inflammatory macrophages and premature differentiation of satellite cells.Genome medicine · 2023Article
- Peripheral arterial disease: A small and large vessel problem.American heart journal plus : cardiology research and practice · 2023Review
- SCAI/ACR/APMA/SCVS/SIR/SVM/SVS/VESS Position Statement on Competencies for Endovascular Specialists Providing CLTI Care.Vascular medicine (London, England) · 2022Article
- Early ABI Testing May Decrease Risk of Amputation for Patients With Lower Extremity Ulcers.Annals of vascular surgery · 2022Article
- Machine learning analysis of multispectral imaging and clinical risk factors to predict amputation wound healing.Journal of vascular surgery · 2022Observational
- Leveraging Machine Learning and Artificial Intelligence to Improve Peripheral Artery Disease Detection, Treatment, and Outcomes.Circulation research · 2021Review
- Fibrosis Distinguishes Critical Limb Ischemia Patients from Claudicants in a Transcriptomic and Histologic Analysis.Journal of clinical medicine · 2020Article
- Clinical impact of improvement in the ankle-brachial index after endovascular therapy for peripheral arterial disease.Heart and vessels · 2020Observational
- Article
- Limb Perfusion During Exercise Assessed by Contrast Ultrasound Varies According to Symptom Severity in Patients with Peripheral Artery Disease.Journal of the American Society of Echocardiography : official publication of the American Society of Echocardiography · 2019Article
- Microvascular Disease, Peripheral Artery Disease, and Amputation.Circulation · 2019Article
- Extensive skeletal muscle cell mitochondriopathy distinguishes critical limb ischemia patients from claudicants.JCI insight · 2018Observational
- SCAI/ACR/APMA/SCVS/SIR/SVM/SVS/VESS Position Statement on Competencies for Endovascular Specialists Providing CLTI Care.Journal of the Society for Cardiovascular Angiography & InterventionsArticle
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Authors and funding
5 authors at 2 institutions in 1 country.
Funding
Abstract
objectivesThis study sought to describe the distribution of pre-intervention treated-limb ankle-brachial indices (ABIs) among patients with critical limb ischemia (CLI) undergoing percutaneous vascular intervention (PVI) or surgical revascularization (SR).
backgroundCLI is diagnosed by the presence of rest pain, tissue ulceration, or gangrene due to chronic arterial insufficiency. It is unclear what fraction of patients with suspected CLI have severe peripheral artery disease (PAD) on noninvasive functional testing.
methodsThe study included patients who underwent lower extremity revascularization for CLI in a multicenter registry in Michigan from January 2012 through June 2015. ABIs were classified as normal (ABI: 0.91 to 1.40), mild-moderate (ABI: 0.41 to 0.90), and severe (ABI: ≤0.40). Pre- and post-intervention Peripheral Artery Questionnaire summary scores were assessed in a subset of patients.
resultsAmong 10,756 patients with signs or symptoms of CLI, 9,113 (84.7%) underwent PVI and 1,643 (15.3%) underwent SR. ABIs were recorded in 4,972 (54.6%) PVI and 1,012 (61.6%) SR patients. Patients undergoing PVI had higher ABIs than those undergoing SR, with substantial variation in both groups (PVI: 0.72 ± 0.29 vs. SR: 0.61 ± 0.29; p < 0.001). Nearly a quarter of patients with compressible arteries had normal ABIs (24.0%), whereas severe PAD was uncommon (16.5%). A significant improvement in Peripheral Artery Questionnaire scores was noted after intervention across all ABI categories.
conclusionsAmong patients undergoing revascularization for CLI in contemporary practice, the authors found substantial heterogeneity in pre-intervention ABIs. The disconnect between ABI results and clinical diagnosis calls into question the utility of ABIs in this population and suggests the need for standardization of functional PAD testing.
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