2021 Volume 54 Issue 2 Pages 89-92
The ankle‒brachial systolic pressure index（ABI）and skin perfusion pressure（SPP）are widely used as diagnostic tools for peripheral arterial disease（PAD）. Although several studies have suggested that higher cut‒off values are needed to detect early‒stage atherosclerosis, which causes PAD, no consensus about this has been reached. In Doppler pulse studies, the loss of reverse diastolic flow indicates the presence of stenosis of ≥20％. Thus, lower limb ultrasonography is considered to be a more useful tool for detecting the early stages of PAD than ABI or SPP. As vascular ultrasound procedures are complicated, we tested the usefulness of Doppler waveform analysis that was restricted to the anterior and posterior tibial arteries. Twenty‒two patients that had been started on hemodialysis within the last year were investigated. Seven out of 11 patients with abnormal Doppler patterns showed no ABI or SPP abnormalities. These results suggest that Doppler waveform analysis can detect early arteriosclerotic changes that cannot be identified using ABI or SPP.
