PAD or LEAD (lower extremity artery disease) is the narrowing of peripheral arteries. It is caused by a build-up of plaque in the arterial walls. This means the blood flow to the limbs is restricted. The most typical symptom is leg pain which occurs during exercise and is relieved by a short period of rest, this is known as intermittent claudication. Most patients, however, do not necessarily feel the leg pain or any other symptoms or are unable to describe them to their doctor.

If a patient has an amputated leg or is not compliant for the ABI measurement because of extensive wounds, it can be measured only on patient’s left or right leg by choosing the “Amputation settings” in the device “Settings” menu.

If the patient can withstand a 1-minute measurement, cuffs must be protected with an impermeable dressing before they are placed on the extremities with wounds. If not, the “Amputation settings” can be chosen in the “Settings” menu and cuffs placed accordingly.

Yes, severe PAD is indicated with a warning and the PAD symbol.

If the patient has severe PAD, the pulse in the ankles is very weak. This means the ABI cannot be accurately calculated. Instead, the device will analyze the pulse waveform and indicate severe disease with a PAD symbol. In the case of a PAD result, we always recommend repeating the measurement with the device connected to the computer. This provides the full-length pulse waveform, which can be analyzed to confirm the condition.

The device has the unique ability to detect severe PAD. In case of severe PAD, the blood flow in the arteries is very much limited and therefore the oscillations, which are essential for the measurement of ankle pressures, might not be present. This is highly dependent on the elasticity of the arteries. If no oscillations are detected, the ABI cannot be calculated, but the device will analyze the pulse waveform and warn you about the presence of severe PAD (with the PAD message). You can confirm the result by examining the full pulse waveforms on the MESIresults report on your computer. If the blood flow is very limited, but there is enough elasticity, the device will calculate the ABI.

If arteries are calcified, the device will show the PAD message. This calls for measurement with the device connected to the computer and examining the shape of the pulse waveform. This can help you deduce, whether the arteries are just calcified or blocked as well.

The device does not detect the arrhythmia per se, but the measurement can be done regardless of it. If due to the condition too many pulses are absent, the algorithm does not have enough data to calculate the ABI and it will show the “E4 error” (“an error occurred during heart rate calculation”). If the condition is not severe, the ABI is calculated as usual.

  • in case of the presence of intravenous cannulas or arteriovenous fistulas, the cuffs and measurement can cause injury to the limb,
  • if the patient has had breast surgery/mastectomy,
  • do not use the device on a patient while they are connected to a vital sign monitor,
  • do not use immediately post-op following a superficial bypass graft without consulting a physician first,
  • do not carry out if the patient has severe lower leg pain or severe lower leg wound pain without consulting a physician first,
  • do not use for patients with dermatitis, pulmonary hypertension, severe hypertension, Parkinson’s or very edematous limbs,
  • do not use with patients who have severe heart failure, gangrene or a recent skin graft on the upper or lower extremity.

MESI ABPI MD is intended only to screen for blocked arteries and not as a diagnostic tool. It is not recommended to use the device on patients with DVT.

Heartbeats create oscillations on the plethysmographic signals, which are used to calculate blood pressure values from three limbs. The ankle cuffs measure oscillometric signals over the whole ankle and hence the highest systolic blood pressure of all arteries (both tibial and dorsalis pedis) within the ankle is detected. The ankle pressure is then compared to the brachial pressure to calculate the ABI.