2016 AHA/ACC Guideline on the Management of Patients With Lower Extremity Peripheral Artery Disease: Executive Summary: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines

. Author manuscript; available in PMC: 2017 Sep 21.

Published in final edited form as: Circulation. 2016 Nov 13;135(12):e686–e725. doi: 10.1161/CIR.0000000000000470


Recommendations for Physiological Testing

COR	LOE	Recommendations

I	B-NR	Toe-brachial index (TBI) should be measured to diagnose patients with suspected PAD when the ABI is greater than 1.40.^66,91–94

I	B-NR	Patients with exertional non–joint-related leg symptoms and normal or borderline resting ABI (>0.90 and ≤1.40) should undergo exercise treadmill ABI testing to evaluate for PAD.^54–59

IIa	B-NR	In patients with PAD and an abnormal resting ABI (≤0.90), exercise treadmill ABI testing can be useful to objectively assess functional status.^54–59

IIa	B-NR	In patients with normal (1.00–1.40) or borderline (0.91–0.99) ABI in the setting of nonhealing wounds or gangrene, it is reasonable to diagnose CLI by using TBI with waveforms, TcPO₂, or SPP.^95–99

IIa	B-NR	In patients with PAD with an abnormal ABI (≤0.90) or with noncompressible arteries (ABI >1.40 and TBI ≤0.70) in the setting of nonhealing wounds or gangrene, TBI with waveforms, TcPO₂, or SPP can be useful to evaluate local perfusion.^95–99