Correlation of Ankle-Brachial Index and Ultrasound Findings on Dorsalis Pedis Artery and Posterior Tibial Artery in Patients with Diabetic Foot Ulcer

Abstract

Introduction: In patients with diabetic foot ulcers, atherosclerosis, and endothelial dysfunction can worsen the patient’s vascular condition. Atherosclerosis is one of which is assessed by the ankle-brachial index (ABI). The occurrence of endothelial dysfunction can be identified indirectly from the examination of flow-mediated dilatation (FMD) via doppler ultrasound. This study was conducted to determine whether there is a correlation between the ankle-brachial index examination with ultrasound examinations of the dorsalis pedis artery and posterior tibial arteries in diabetic foot sufferers. Method: The study design was a cross-sectional prospective conducted on 11th November – 15th December 2014 at Cipto Mangungkusumo National Hospital, Fatmawati National Hospital, and Tangerang Hospital. The inclusion criteria used were diabetics and allow for ABI examination and ultrasonography. Patients who did not have a precise diagnosis and had undergone a major amputation of the leg examined were excluded from the study. Results: From the Spearman non-parametric correlation analysis test results obtained significant results on the correlation between ABI and posterior tibial artery volume flow (VF) (p=0.021). In contrast, insignificant results were obtained on the correlation between peak systolic velocity (PSV) dorsalis pedis artery with ABI (p=0.561), as well as an insignificant correlation between VF of dorsalis pedis artery with ABI (p=0.143), as well as insignificant correlation on PSV of posterior tibial artery with ABI (p=0.231) The results of Spearman’s non-parametric correlation analysis test results obtained significant results on the correlation between ABI and ABI spectral picture (p=0,000) in the diabetic foot. Conclusion: There was a significant correlation between the posterior tibial artery VF with ABI and the Doppler ultrasound spectral picture with ABI. Keywords: ultrasound doppler, ankle-brachial index, diabetic foot ulcer, dorsalis pedis artery, popliteal artery