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We recently did a study evaluating this very problem. 
 
Journal for Vascular Ultrasound <http://mail.pvasatx.com/content/svu/jvu> , Volume 31, Number 3, September 2007 , pp. 149-151
"Using ABI alone for screening in a population with a high incidence of diabetes is significantly limited because of noncompressible ankle pressures caused by arterial calcification....The prevalence of PAD, detected by Doppler waveform analysis in the segments with non-compressible ankle pressures, was 69%. Additional modalities such as Doppler waveform analysis would further increase the accuracy of screening for PAD in this population. Alternately, using the ABI alone for the detection of PAD can be improved by interpreting ABIs greater than 1.2 as positive results because of the high prevalence of PAD in this group."
 
So in a nut shell, use waveform analysis in patients with noncompressible arteries. 
 
Peter M. Richard, BS, RVT
Peripheral Vascular Associates
San Antonio, Texas

________________________________

From: UVM Flownet on behalf of Barb Lemon
Sent: Thu 12/20/2007 2:18 PM
To: [log in to unmask]
Subject: Noncompressible ABI's and screening



For those of you that do free ABI's for screening purposes, how do you
report those patients who are non compressible?   Is there a non
diagnostic component to the report?  Do you also report on the Doppler
sound ( monophasic )?  We are scheduled to screen at a diabetes fair
soon, any help is as always greatly appreciated  Thanks Barb.

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