Incompressible lower limb arteries in Malaysian patients with diabetic foot complications

Abstract

Clinicians frequently feel uneasy when faced with the task of interpreting ankle systolic pressure and ankle brachial indices in diabetic patients. Although it is well known the ankle systolic pressures and ankle brachia! indices may be spuriously elevated in diabetics due to medial calcific stenosis, and the resulting incompressibility of peripheral arteries, the prevalence of this phenomenon has not been widely addressed. This phenomenon was observed in 4 of 43 (9.3%) Malaysian patients admitted to Hospital Kuala Lumpur for diabetic foot complications and in whom ankle systolic pressures were measured. Incompressibility was not observed in all the three lower limb arteries. This relative low prevalence suggests that the ankle brachial index measurement can still be a useful screening procedure for the presence of peripheral arterial macrovascular disease especially measured in all 3 lower limb arteries and interpreted in conjunction with other clinical parameters of arterial evaluation.