Ankle and toe systolic pressures comparison of value and limitations in arterial occlusive disease

Ankle and toe systolic pressures represent the most convenient and useful measurements in the assessment of limbs with arterial occlusive disease. Each is a sensitive index of the presence and severity of the arterial obstruction and they both correlate with angiographic findings and with the severity of the symptoms. The measurements can be used to follow individual patients, to study the natural history of the disease, to assess prognosis and plan management, and to evaluate long-term results of surgical and transcutaneous interventions. However, because of the limitations of the ankle pressures related to the rigidity of the arterial walls of the tibial vessels and the more distal site of the measurement in the toes, measurements of pressure in the toes should be included in the evaluation of arterial disease in all patients with diabetes, and in all limbs with severe ischemia.