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Duplex detected ankle peak systolic velocity: a new parameter for the assessment of degree of peripheralischemia.

AIM
The objective of this study was to assess the sensitivity and specificity of a newly developed parameter: the ankle peak systolic velocity (APSV) to provide an objective assessment of the degree of peripheral ischemia.


METHODS
In phase 1 of the study: data was prospectively collected for 21 ischemic limbs and 5 healthy volunteers. APSV was calculated as the mean value of the distal anterior and posterior tibial arteries peak systolic velocities (PSV). Ankle brachial index (ABI) was calculated for the anterior tibial and posterior tibial arteries. A mean ABI for both tibial arteries was also calculated. APSV was correlated with the mean ABI. Cut off values were calculated to differentiate critical, moderate and no ischemia. In phase 2 of the study data was prospectively collected for 37 ischemic limbs and 5 healthy volunteers, to assess the sensitivity and specificity of the cut off values of the APSV to identify limbs with critical ischemia, moderate ischemia, and no ischemia.


RESULTS
APSV correlated strongly with the mean ABI (r=0.8, p<0.01). The sensitivity and specificity of APSV in identifying critical ischemia were 90% and 87%, for moderate ischemia they were 75% and 88%, and for differentiating limbs with any degree of ischemia from normal limbs they were 100% and 100%, respectively.


CONCLUSIONS
APSV can be used as an alternative to ABI for the assessment of degree of peripheral ischemia.