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Acceleration time and maximal acceleration in lower extremity peripheral artery disease: Measurements and application
Jean-Eudes Trihan1, Guillaume Mahé2, Damien Lanéelle3
1Vascular Medicine Unit, Cholet Hospital, Cholet, France; Department of Vascular Medicine, Angers University Hospital, Angers, France.
Vascular Diseases (Paris, France)
|June 1, 2026
Summary
Acceleration time (AT), a Doppler ultrasound parameter, is valuable for diagnosing peripheral artery disease (PAD) when other methods fail. This review highlights its practical use in assessing PAD severity and guiding patient management.
Area of Science:
- Vascular Ultrasound
- Hemodynamics
- Peripheral Artery Disease
Background:
- Acceleration time (AT) is a pulsed-wave Doppler ultrasound parameter.
- AT has remained underutilized despite its description decades ago.
- Recent evidence highlights AT's value in lower extremity peripheral artery disease (PAD), especially when ankle-brachial index is unreliable.
Purpose of the Study:
- Provide a comprehensive overview of AT in PAD.
- Focus on physiological basis, measurement techniques, and clinical applications.
- Emphasize standardization and reproducibility for accurate assessment.
Main Methods:
- Review of physiological basis and technical requirements for AT measurement.
- Standardized measurement conditions and common pitfalls discussed.
- Analysis of diagnostic performance across arterial levels and in advanced PAD.
Main Results:
- AT effectively detects significant upstream stenoses and excludes hemodynamically relevant disease with high sensitivity and specificity.
- Maximal acceleration time (ATmax) in pedal arteries is a reliable marker of severe hypoperfusion in advanced PAD.
- Maximal systolic acceleration (ACCmax) offers complementary hemodynamic insight.
Conclusions:
- AT, ATmax, and ACCmax are simple, reproducible, non-invasive markers enhancing PAD assessment.
- Systematic integration into clinical practice can improve diagnostic accuracy and patient management.
- These Doppler parameters offer significant value in evaluating PAD severity and guiding treatment decisions.
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