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Arterial Procedures > ABI's > Flashcards

ABI's Flashcards

1
Q

What symptoms does a hemodynamically significant obstruction cause?

A

It causes symptoms in the LE of claudication, rest pain, gangrene, and ulceration.

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2
Q

What does a hemodynamically significant obstruction do to a waveform?

A

It causes a change in the waveform pulsatility distally due to arterioles opening and changing resistance.

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3
Q

What does a hemodynamically significant obstruction do to the pressure?

A

It causes the pressure to drop distally to the obstruction.

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4
Q

How does the ankle and brachial pressures compare?

A

Ankle pressures should be higher than the arm.

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5
Q

What does a decrease in the ankle pressure indicate?

A

It is an indication of an obstruction proximally causing a pressure gradient, therefore lowering the blood pressure at the ankles.

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6
Q

What do ABI’s measure?

A

They measure the pressure change distal to significant obstruction.

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7
Q

What do ABI’s indicate?

A

They indicate the presence of a hemodynamically significant obstruction as well as the severity of the decrease perfusion it has caused in the ankle level.

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8
Q

What does ABI stand for?

A

Ankle/Brachial Index

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9
Q

How do you calculate the ABI?

A

The systolic pressure at the ankle is measured and divided by the brachial artery systolic pressure.

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10
Q

What is the equation for ABI?

A

ABI= Ankle Pressure/ HIGHEST Brachial Pressure.

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11
Q

What position should ABI’s be measured in?

A

A patient MUST be measured in supine.

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12
Q

What size cuff should you use ?

A

10-12 cm wide.

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13
Q

Where should you obtain the best doppler signal?

A

DIstal to the cuff at the DP, PT, and brachial arteries.

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14
Q

Where should you measure the pressure in an ABI?

A

DP, PT and brachial arteries.

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15
Q

What happens if its not audible?

A

You move up to listen distal ATA, PTA, or PER A or move down to hear radial.

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16
Q

When taking a pressure measurement, what should you inflate the cuff to?

A

Inflate the cuff 20-30 mmHG over the last audible sound.

17
Q

What should you listen to as you deflate the cuff 2-4 mmHg?

A

LIsten for the first sound, and note pressure, and continue to listen for continuation of pulses.

18
Q

Will listening for the point the signal disappears on inflation yield an accurate pressure?

A

No!

19
Q

When should you document the brachial pressures?

A

You should document brachial pressures when they are 20 mmHg different from each other, or do not sound multi-phasic, document the waveform.

20
Q

What does a ABI interpret?

A
  • Presence of disease
  • Severity of disease
  • Any changes
21
Q

What is considered a normal ABI?

A

> .95 (asymptomatic)

22
Q

What is considered a mild ABI?

A

.80-.95 (claudication)

23
Q

What is considered a moderate ABI?

A

.50-.79 (claudication)

24
Q

What is considered a severe ABI?

A

.30-.49 (possible rest pain)

25
Q

What is considered a critical ABI?

A

Less than .30

26
Q

If an ABI is >.50, what does this indicate?

A

It is likely there is only a single-level of obstruction.

27
Q

What does it mean if an ABI is less than .50 (

A

It is likely there are multi-levels of obstruction.

28
Q

What determines a follow up?

A

Changes in ABI’s from one study to the next.

29
Q

What is a possible significant change?

A

> .15

30
Q

What is a probable significant change?

A

> .20

31
Q

What 3 things should you avoid when doing an ABI?

A
  1. Moving the probe while inflating the cuff.
  2. Pressing the DP too hard and compressing it with the probe.
  3. Not calming the patient.
32
Q

What is the biggest limitation to an ABI?

A

Calcification.

33
Q

Why is calcification a big limitation to an ABI?

A

If calcification is present in the arterial wall or in the plaque it is harder to compress the artery with the cuff. This results in a falsely elevated pressure that may miss disease or indicate that it is better than it truly is.

34
Q

When should you suspect calcification is affecting the pressure?

A

When the ABI >1.35 and when the doppler and waveform disagree.

35
Q

Which patients are susceptible to calcification?

A

Diabetics and renal failure patients.

36
Q

What are some of the advantages of an ABI?

A
  • Simple equipment
  • Relatively easy to learn and execute
  • Presence, severity and progression of disease in a simple test.
  • Accurate
37
Q

How can you improve the accuracy of an ABI?

A

to counteract the potential problems with each technique, doing BOTH ABI’s and DP and PT waveforms can improve accuracy.

38
Q

TRUE OR FALSE: ABI’s with elevated pressures due to calcifications will have EXCELLENT pedal artery waveforms.

A

FALSE. They will have worse pedal artery waveforms.

Arterial Procedures (13 decks)

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