STUDENCKIE KOŁO NAUKOWE
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CHIRURGII OGÓLNEJ I NACZYNIOWEJ

Międzyleski Szpital Specjalistyczny w Warszawie


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Ankle – brachial index – pilot diagnostic study in patients at high risk for peripheral arterial disease
Magdalena Majkowska, Sławomir Poletajew, Maciej Walędziak, Małgorzata Litwiniuk, Krzysztof Hałabuz
Supervisor: Tadeusz Mularczyk MD PhD

Students’ Scientific Society of General and Vascular Surgery, Miedzyleski Specialist Hospital in Warsaw
Head of department: Waldemar Kostewicz MD PhD, Ass. Prof.


The ankle – brachial index (ABI) is a simple and reliable test which may be useful in diagnosing of peripheral arterial disease (PAD) of the lower extremities. It may be used to detect the disease or to predict its severity and helps to evaluate the development of PAD and the response to treatment. It should be performed in every case of PAD and particularly in asymptomatic patients with risk factors. The most frequent risk factors for PAD are: age and sex of the patient, hypertension, coronary heart disease, myocardial infarction and cerebral stroke in history, diabetes, hyperlipidaemia, smoking and positive family history of PAD.

Aim
The aim of the study was to evaluate usefulness of the ankle – brachial index to diagnosing of PAD in the group of patients with some risk factors, and to present the variability of ABI in male patients above 50 years old and to compare the results with clinical findings.

Material and methods
From Oct 2007 till Feb 2008 (5 months) the measurement of the ABI was performed in 166 male patients over 50 years old, who were admitted to the Department of General and Vascular Surgery, Internal Medicine, Neurology, Laryngology and to the Emergency Department of Międzyleski Specialist Hospital of Warsaw. The blood pressure was taken with the use of the Doppler probe and sphygmomanometer. Every patient was also asked to respond the questionnaire detecting risk factors, history of the diseases and the symptoms and signs of PAD.

Results
In 166 patients included in the study following risk factors were present: smoking in 117 (70,5%) cases, hypertension - 82 (49,4%), coronary heart disease in 63 (38%) cases, hyperlipidaemia - 56 (33,7%), heart infarction - 50 (30,1%), diabetes - 34 (20,5%) and cerebral storke in 9 (5,4%) cases. The value of the ABI ranged from 0,56 to 1,5 (mean 1,04). In 24 (14,5%) patients ABI was moderately decreased (< 0,9). Clinically relevant manifestation of PAD such as intermittent claudication or rest pain was found in 9 (41,7%) patients of this subgroup.

Conclusions
The ankle – brachial index is simple and non-invasive method. The ABI is a good predictor for PAD and may help to detect the disease in early and asymptomatic phase. It could be included in routine screening of vascular system, especially in patients with high risk factors. Patients with a low ankle – brachial index may require additional monitoring and perhaps treatment.


PUBLIKACJA PRACY:
niebawem..

PREZENTACJA PRACY:
5th International Scienfitic Congress of Medical Students and Young Doctors. Warsaw, 25-27 April 2008.