Introducing the British Lymphology Society position paper on ankle brachial pressure index

Prompt application of appropriate compression therapy is essential for effective treatment of lymphoedema. However, it is accepted that prior to the application of compression to the lower limbs, either with bandaging or compression garments, patients should demonstrate a satisfactory vascular status, as assessed via axillary brachial pressure index (ABPI). Unfortunately, the presence of peripheral oedema may render a reading impossible or grossly inaccurate. Relying solely on ABPI assessment is potentially harmful to patients, who may be denied appropriate treatment or experience complications and deterioration of their condition due to delayed treatment. The British Lymphology Society recognises a need to focus more on clinical assessment skills to determine vascular status, rather than relying on ABPI alone. Thus, the Society has developed guidance and a practical tool to support clinical decision-making and enhance practitioner confidence in the safe application of compression therapy in the absence of ABPI.