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Assessment of Lower Extremity Peripheral Arterial Disease Using a Novel Automated Optical Device

Vascular Unit, Royal Free Hampstead NHS Trust Hospital, London

Adrien Boutin, MSc

Vascular Unit, Royal Free Hampstead NHS Trust Hospital, London

Vincent P. Crabtree

Vascular Unit, Royal Free Hampstead NHS Trust Hospital, London

Dimitri P. Mikhailidis, MD

Department of Clinical Biochemistry and Department of Surgery, Royal Free Hospital and University College Medical School, London

Alexander M. Seifalian

Academic Division of Surgical and Interventional Sciences, University College London, a.seifalian{at}medsch.ucl.ac.uk

George Hamilton, FRCS

Academic Division of Surgical and Interventional Sciences, University College London

The resting ankle-brachial pressure index (rABPI) is used in the diagnosis of lower extremity peripheral arterial disease (PAD) in symptomatic and asymptomatic patients. This article compares the rABPI with a new optical device based on photoplethysmograph (PPG) technology with new algorithms for the assessment of PAD. Functional PPG (fPPG) is a promising noninvasive automated device using a novel cuffless functional test for assessing mild or significant PAD without the operator dependency issues associated with rABPI. This system utilizes both changes in pulsatile arterial blood volume and skin color redness in lower limbs. All subjects underwent rABPI, fPPG, and duplex angiography (DA). Significant correlation was found between fPPG and DA scores, rABPI and DA, and fPPG and rABPI. In the hands of operators with little experience, fPPG may prove to be superior to rABPI and may be useful as a simple screening tool for early detection of PAD in primary care.

Key Words: peripheral arterial disease • ankle brachial pressure index • photoplethysmography • duplex angiography

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