Understanding Ankle Brachial Pressure Index (ABPI) in Peripheral Vascular Disease

A visual explanation of the ankle brachial pressure index can assess the severity of atherosclerosis in patients with peripheral vascular disease.
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DISCLAIMER: This video is for education and entertainment only, and is not medical advice. This video should NOT be used for medical advice or to guide clinical practice. The Zero to Finals content should not be used in any way to guide medical decision making. Zero to Finals takes no responsibility for any actions taken or not taken based on the information provided. Local and national guidelines and senior clinicians are there to help you make decisions, not CZcams videos. If you need medical advice or information, seek it from an appropriately trained and licenced doctor or healthcare provider that can address your individual needs. Zero to Finals cannot guarantee the accuracy of information in this video. Please highlight any errors you notice in the comments below - thank you.

[@mom_doc]

Thanks for a simplistic and clear explanation. Basically, its all about ratios, and you've explained that very nicely, and the numbers now make sense. I will never forget it now!

[@YourTechGuide.]

*Thanks for the information. I will definitely be using this today*

[@dianerodriguez6546]

You are a great teacher, as evidenced by all your educational videos 😊

[@jackblack4367]

Great Animated Video. great explanation. I m a personal trainer and I've seen some people with severe PAD, and this helps me to explain to my clients. I've had difficulties in trying to understand Blood Pressure and the best way to understand BP. Thanks

[@admoh8835]

Thank u , you finally relieved my dyspnea on this topic

[@keichitsuchiya6472]

HAHAHAHAHHAHA

[@edwinaye9292]

Excellent as always Tom…much gratitude

[@rkpdalbir]

Thanks for sharing your professional knowledge and experience with public for good. I have same test next week, now I am well prepared to understand and question about outcome of my test.

[@orlean110]

An ABI above 1.40 suggests noncompressible vessels, which may reflect medial calcification but is not diagnostic of flow-limiting atherosclerotic disease. An ABI greater than 1.40 is associated with worse cardiovascular outcomes than a normal ABI. In such patients, an appropriate next step is to either measure great toe pressure or calculate a toe-brachial index (systolic great toe pressure divided by systolic brachial pressure). Vessels within the great toe rarely become noncompressible, and a great toe systolic pressure below 40 mm Hg or a toe-brachial index of less than 0.70 is consistent with PAD.
Source: MKSAP17

[@karenb6547]

Would you then stop compression if ABI is above 1.4 since vessels are noncompressable?

[@stacieklueber6340]

So if arteries are calcified ABI is on reliable?????? I thought the definition of arteriosclerosis IS calcification?!

[@jorgeizquierdo9265]

Life saver video!!! Thank you

[@lizziesargeant1250]

Very straightforward to understand. I wish that the nurse who took my pressures would have explained that, then I wouldn't have had to watch this!

[@546pastelpink5]

You're an absolute life saver, thank you!

[@royksk]

Very clear and concise; excellent video

[@awsqudsi3953]

Beautiful explaining way. Thank you.

[@PamelaMaryGreen1]

Very well explained. I understand why I have to have it done now! Thank you!

[@ZeroToFinals]

glad it helped.

[@TubeTelivision]

Your videos are always the BEST! Thank you!!

[@ZeroToFinals]

Thanks Holly

[@gillianquinn8806]

Simple ,easy explanation. Thanks

[@vaishnavibansode2874]

Thanks for the clear explanation ❤

[@NualaLou]

Very simple and easy to understand. Thank you!

[@ZeroToFinals]

Thanks!

[@saminamunshi2031]

You have explained so beautifully 👍

[@graceusa3942]

great teaching, thank you.

[@tessakhairy6876]

Thank you so much, great explanation Tom! And to Harry Watchman for perfectly editing

[@rainandcoffee6426]

You make it so clear thank you

[@SkyNikodell]

Thank you for this easy and digestable explanation

[@ZeroToFinals]

You're welcome.

[@user-vo3kq9dp1r]

Wonderful, thank you so much

[@FemieAdesina]

Thanks for the simple explanation

[@qamarfallatah8636]

It was so brief and super beneficial to me, thank you a bunch

[@ZeroToFinals]

Glad it was helpful. I don't believe in making it longer for the sake of it!

[@daglan263]

I did enjoy this video, thank you so much !

[@antoinetteabouantoun1530]

thank you for the clear and simple explanation. it surely helped.

[@ZeroToFinals]

No problem. glad youfound it!

[@liljanakaca2199]

Excellent video.

[@stuartbrignell9457]

Excellent explanation, I must arrange to have the test carried out. Thanks for your input. Regards Stuart.

[@ateequrrahman6847]

Thank you very much for good information .

[@AdrianaChrite]

THANK YOU! I finally understand

[@ZeroToFinals]

You are very welcome Adriana. glad it helped!

[@neverlady]

So very helpful, thank you

[@sumitdaniel6630]

Thanks that was Great!🙏💐

[@tomchristian9932]

Awesome info thank you!

[@saharkhaled5863]

You're perfect
Thank you so much

[@adelAl-abd]

>1.4 indicates non compliant arteries
1.0 ~ 1.4 normal
0.91~.99 borderline
< 0.9 Abnormal
< 0.5 Sever arterial disease, risk of critical limb ischemia

[@vudat189]

what if they said left ABI or Right ABI but i dont have number of the right hand ?

[@imteyazurrahman]

Very good... explained nicely.... there is need to evaluate how narrowing of arterial lumen affects pressure and volume of blood passing thru it .

[@syedsajjad7935]

Big thanks for the easy understanding. :)

[@ZeroToFinals]

You are welcome!

[@queenabiola1282]

Thanks alot for the explanation❤

[@catn9608]

so helpful, thanks so much!!

[@joeythestuntmaster6210]

Great, informative video!

[@ZeroToFinals]

Thanks Joey

[@shraddhakanade951]

Thank you so much!!⭐

[@karynmorris2406]

Many thanks

[@hh-zq9io]

Thank u million times

[@haleemachaudhry7346]

You're amazing.

[@Ungorgeousgirl]

excellent video aand thank you

[@Marc_de_Car]

Thank you

[@chetorihenson]

Thank you!!!!

[@Satyaki0059]

All the videos im CZcams explaining ABPI didnt tell which pressure we have to count? After watching this video I have understood to count only the systolic Bp. Thanks mate !

[@shwesinlay.557]

Thanks doctor

[@DR.PATO_7]

thank you very much

[@zahraaalialhares6086]

Thank you.🤍

[@user-yz4nc4sl2v]

Very nice video

[@sanjulawickremasinghe3793]

Thank you 💖

[@tariqhassan7306]

Thank you sir.

[@ismaelhernandez1596]

very nice understood

[@lwill53951]

thank you always wanted to know that because of swelling below both knees

[@user-yo8jy4ur1y]

Excellent 👏 thanks

[@sameharean1902]

Thanks Dr

[@AditiPantVlogs]

Great explanation

[@ZeroToFinals]

Thank you!

[@duammd6646]

Thak you so much

[@mohanadshareef4651]

Brilliant

[@danielshively9778]

So what happens if your blood pressure is higher in your leg then your arm?

[@nickichin9979]

Thanks

[@Mail4Lisa]

Great video,thanks!! What is a normal reading for ankles! I did this to my family member and right arm was 122 ankles was 140 & 130?

[@petermorris9868]

What happens when you get readings which are 1.3 and above. CKS guidelines recommend a referral. But what does that mean in regards to pathophysiology/disease?

[@sherilpinnock1639]

thanks

[@rathodnehal2869]

great 😊 sir 🙏🙏

[@jimmiller6704]

Can a normal bp machine in a docs office be used to determine this?
Why is it not done at every physical?
I've complained every time I've gone to the doc about cold feet, no hair growing on my legs and no doc ever took a look at this for me.
Why are our docs so poorly trained in this?
Not sure where you're from, I'm Ontario Canada, I've asked for this test to be done repeatedly by different docs they always refuse.
Great explanation, thanks.

[@vudat189]

what if they said left ABI or Right ABI but i dont have number of the right hand ?

[@hf7488]

شكررا جزيلًا

[@kaushikbhagat8272]

At ankle wch artery should be auscultated for BP measurement?

[@lazarocardenas5742]

good video thanks

[@ZeroToFinals]

Thanks for your comment Lazaro. Glad to help

[@mohamedhelmy7620]

GREAT

[@1234jally]

Quite informative however no mention of above 1.3

[@user-ii2gm3fu8x]

Can you do this at home with a home monitor

[@pakostnik1]

You didn't mention that ratio above 1.3 is as alarming as ratio readings under 0.9.
Readings above 1.3 or some findings above 1.4 means calcification of arteries.

[@travelightly]

Чикатило, why is a reading below 0.9 alarming?

[@KiCkFLiPKiCkFLiP]

@@travelightly Watch the video...

[@stacieklueber6340]

I thought artherosclerosis WAS calcification of arteries?????

[@Rebecca75100]

Thanks but wldn't it be painful fr the patient, to record d BP on d affected leg?

[@catherinewangeci5226]

Greaaaat

[@Richard-od1vu]

If I have….lets say 120/80 in arm, I want to have 120 or more in ankle?

[@lindapestridge3073]

Hi Richard
did you find the answer
I wanted to know the same
as you .

[@PrajwalBikramKC]

Yes the pressure will be more in ankle compared to brachial because the heart and the the brachial artery lies adjacent to each other so same level whereas the ankle is the lowest as compared with the pumping organ heart so will have more depth and we know the formula P=HDG where p is pressure and h means height so pressure is directly proportional to height or depth. As ankle have more depth pressure will be more.
I hope it may help you🥰

[@lindapestridge3073]

​@@PrajwalBikramKCoh thank you so much that is so kind of you to
reply .

[@dianamartell1601]

A value higher than 1.3 could indicate calcification, which isn't good. So a value of 1-1.3 is generally normal and healthy. But past 1.3 would not be a good finding.

[@johnarthur4736]

Should you do both the arm and the ankle readings lying down or sitting? Thank you.

[@ZeroToFinals]

Good question. Lying down.

[@tuunis3293]

Less, time more benefit Good video

[@4michaelmccann]

Thank you for this explanation. This test assumes the benchmark is the arm. What if the arm pressure is flawed? Why not measure it against a much more reliable benchmark? Why does it only measure the feet? what if you only have PAD in your hands?...So many questions

[@stacieklueber6340]

You won’t have it in your hands. Your legs are further from the heart

[@inneralpha]

So ankle brachial index uses the highest pressures from the arm and ankle? So you would have to measure both arms and both ankles before obtaining a final results?

[@venomx4093]

Yeah confusing as my bp reads different from 1 minute to the next in either arm. It may read 135/80 and 1 minute later read 110/72 which will give 2 totally different totals. My ankles do the same thing.

[@hunter6099]

What if the leg is way higher then the arm #?

[@melbaround]

What if abi is higher, 1.93? I know i have calcification in my heart vessels. Also i have hypoxia, could this potentially be the cause? Anyone? I've been to 100 docs and its still not clear.

[@emilshipp1623]

What exactly is Hybetez Remedy? How does this thing really work? I see many people keep on talking about this high blood pressure remedy.

[@hussainabbas9260]

when can I say it's acute ischemia or chronic ischemia ?

[@philipbrainard7122]

Are you standing, sitting or lying down when testing

[@Divocwax]

That's all very clear - almost. But what position is the body when taking the two comparative readings? Your diagram shows a standing person. Should not the person be lying down?

[@ZeroToFinals]

Yes, you are correct. Best to do them lying down

[@istvanfigueroa1406]

What about bigger than 1.4?

[@albabop5993]

Its important to remember arteriosclerosis can throw out an elevated ankle reading and skew the ratio.

[@yesno2995]

Good

[@jeffreyscottfishman]

My number was 1.7. ... are you sure a higher number is a problem? Im an athlete with a consistant blood pressure of 108/70. 5'6 140lbs and 32 inch waist maybe closer to 31 actually. My hearbeat averages 60-65...9 out of 10 times . Follow a ketogenic diet and feel great with tons of energy. Run 3 - 4 miles a day and workout 4 times a week. Glucose level is 85 consistantly through out the day. Should i still worry about the Abi?

[@nickbardan3867]

Did you find an answer? I'm in the same numbers

[@abrin5508]

You lie down for a few minutes to take reading on ankle. If you are vertical you get odd readings.

[@mikerod76]

Arm 127 and leg is 153. Is that bad?

[@tonygirard3307]

My condition was

[@rnblovaa]

How did you get help what were your symptoms?

[@AhmedAhmed-vo5mh]

عاشت ايدك بالعراقي 😂❤

[@jbrdbr111]

So the ankle is 161, and the arm is 119. It seems high at the ankle. My calculation is 1.35 if it's the leg divided by arm

[@Joseph8961]

Why vessel calcification will have a picture greater than 1.2