The European Society of Cardiology (ESC) 2024 Guidelines for the Management of Peripheral Arterial and Aortic Diseases emphasize the crucial role of early diagnosis and intervention, particularly using the ankle-brachial index (ABI) and toe-brachial index (TBI). This blog highlights key updates from the guidelines, focusing on the latest recommendations for PAD detection and clinical management.
The ankle-brachial index (ABI) is a simple, cost-effective, and non-invasive test that compares the systolic blood pressure at the ankle and the arm.
According to the latest ESC guidelines:
For patients with diabetes, chronic kidney disease, or medial arterial calcification, ABI measurements may be unreliable due to non-compressible arteries. In these cases, the toe-brachial index (TBI) provides a more accurate assessment. TBI measures toe pressure using laser Doppler or plethysmography, with a pathological threshold of ≤0.70 being indicative of PAD.
1. The guidelines introduce a classification system dividing peripheral arterial disease (PAD) into three main categories:
2. The ESC guidelines also discuss the role of transcutaneous oxygen pressure (TcPO2) in assessing tissue viability:
3. Given the high cardiovascular risk associated with PAD and aortic diseases, the guidelines highlight the importance of screening for obstructive coronary artery disease (CAD). Utilizing coronary computed tomography (CT) is recommended for its accuracy and efficiency in diagnosing CAD, which is vital for tailoring revascularization strategies and optimizing medical therapy.
4. Patients experiencing exertional limb pain but having a normal resting ABI should undergo exercise testing with post-exercise ABI measurement or exercise oximetry to diagnose lower-limb arterial stenoses. However, the guidelines note discrepancies in post-exercise ABI criteria, highlighting the need for careful interpretation to avoid false positives.
At MESI, we understand the importance of reliable and efficient PAD diagnostics. Our MESI mTABLET ABI and MESI mTABLET TBI provide oscillometric-based ABI and TBI measurements, ensuring:
The 2024 ESC guidelines emphasize the need for proper physician training to achieve better reproducibility in ABI and TBI measurements. MESI mTABLET ABI and TBI are designed to support standardized and reproducible diagnostics, enabling healthcare professionals to detect PAD early and optimize patient outcomes.
With PAD being a strong predictor of cardiovascular disease and mortality, early and accurate detection is crucial. The 2024 ESC guidelines reaffirm ABI and TBI as fundamental diagnostic tools, with MESI’s advanced mTABLET solutions helping physicians perform fast, reliable, and digitalized arterial assessments in everyday clinical practice.