Demographic change, the rise in chronic diseases like diabetes, and increasing pressure on medical staff all highlight a clear need: Efficiency in screening and diagnostics is no longer a “nice-to-have” – it’s a necessity. At the same time, medical findings must remain reliable and evidence-based, especially when it comes to the early detection of peripheral vascular disease (PVD).
The good news: Modern vascular screenings can now be structured, delegable, and multiparametric – using systems that go beyond the traditional ABI.
ABI Alone? Not Always Enough for Effective Screening
The Ankle-Brachial Index (ABI) has long been a standard parameter in vascular diagnostics. However, in clinical practice, a “normal” ABI value doesn’t automatically mean healthy arteries.
Especially in at-risk patient groups – such as those with diabetes mellitus, hypertension, or medial arterial calcification – the ABI can be misleading (read more in our blog article: “When ABI Isn’t Enough: Why TBI & PWI™ Matter In Vascular Diagnostics“). Stiffened, calcified arteries often lead to falsely elevated ankle pressure readings and thus to seemingly normal ABI results, even when relevant perfusion deficits exist. This can lead to a false sense of security and delayed diagnosis.
A 2020 analysis by AbuRahma et al. concludes that patients with diabetes or impaired kidney function frequently present falsely elevated ABI values despite underlying PVD.¹ Similarly, a recent study by Singhania et al. (2024) confirms that the Toe-Brachial Index (TBI) shows significantly higher sensitivity in detecting PVD in patients with type 2 diabetes compared to the traditional ABI.²
In these high-risk groups, alternative parameters such as TBI or the blood pressure-independent Pulse Wave Index (PWI™) provide crucial added diagnostic value – especially for early detection.
Smarter Screening Through Multiparametric Systems
Modern systems like AngE™ from SOT Medical Systems combine multiple parameters into a structured workflow – simple, delegable, and completed in just 1 minute per examination.
Key parameters at a glance:
- ABI (Ankle-Brachial Index) – traditional baseline parameter
- TBI (Toe-Brachial Index) – ideal for medial sclerosis and diabetic patients
- PWI™ (Pulse Wave Index) – blood pressure-independent, detects post-stenotic flow changes
- PWV (Pulse Wave Velocity) – identifies arterial stiffness
This combination enables a more comprehensive view of vascular health, delivering clear and valid results even in complex risk scenarios.
Delegable Workflows Ease Clinical Burden
The challenge in many clinics: too little time, too much demand.
This is where systems like AngE™ come in. They enable:
- Standardized workflows that can be delegated to trained staff
- Fast testing (1 minute), no blood pressure cuffs required
- Automated documentation for recordkeeping and follow-up
- Reduced burden on physicians and more efficient use of resources
Especially in interdisciplinary settings – such as diabetology, internal medicine, or vascular clinics – early screening can be seamlessly integrated without disrupting existing workflows.
Conclusion: Holistic, Efficient Screening – Not One-Dimensional
Clinics that adopt modern screening systems benefit in two ways: they gain quick, reliable diagnostic data and can optimize internal processes without sacrificing diagnostic depth.
The key lies in the combination: No single parameter alone tells the full story – but smart integration of multiple indicators such as ABI, TBI, and PWI™ does.
Want to take your vascular screening to the next level? 📩 Contact us – we’re happy to support you in integrating the AngE™ systems into your clinical processes.
Sources:
¹ AbuRahma AF, Avgerinos ED, Bakaeen FG et al. (2020): “The limitations and pitfalls of ankle–brachial index in patients with diabetes and chronic kidney disease“. In: Journal of Vascular Surgery. https://pubmed.ncbi.nlm.nih.gov/31471230/
² Singhania N et al. (2024): “Diagnostic utility of toe-brachial index versus ankle-brachial index for peripheral artery disease in patients with type 2 diabetes mellitus.” In: Diabetology & Metabolic Syndrome, 16(1):23. https://dmsjournal.biomedcentral.com/articles/10.1186/s13098-024-01291-2
