Abstract
This paper highlights the need for a more accurate noninvasive test to measure perfusion in patients with peripheral artery disease and medial calcinosis from diabetes, age, or chronic kidney disease.1 Traditional ankle-brachial index measurements (ABIs) lack reliability in these patients, and even normal values can be misleading. Correlation with pulse volume recordings or Doppler waveforms can provide insight into an underlying arteriopathy with “normal” ABIs. The adjunctive use of toe pressures is sometimes helpful but is limited in patients with severe disease or in the setting of prior toe amputations.
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