Sanjay Misra, M.D.

Accurate noninvasive limb perfusion assessment is vital for prompt diagnosis and prevention of unnecessary invasive procedures for patients with inadequate blood flow and related ulcers. That’s according to a recent American Heart Association scientific statement.

Thorough evaluation of limb perfusion includes the ankle-brachial index, toe-brachial index and other perfusion technologies. Telemedicine technology also may provide better access to care, the authors said. They also pointed to differences in comorbidities and presence of critical limb ischemia among patients of different ethnicities, which can make diagnosis and management more challenging. 

“Compared with white patients, black and Hispanic patients have higher prevalence rates of diabetes mellitus and chronic renal disease, and are more likely to present with gangrene, whereas white patients are more likely to present with ulcers and rest pain,” the authors noted in the statement. 

More than 12 million people in the US have peripheral artery disease, the most severe form of critical limb ischemia. The disease is prevalent in those over the age of 65, although only half of elderly people known to have the condition are symptomatic. If arterial blood flow in the lower extremities is limited, tissue breakdown can occur, and there’s an increased risk for cardiovascular-related events, amputation and mortality. The scientific paper was published online Monday in Circulation.