Therefore, when the pulse of the posterior tibial artery is not detected by Doppler, a diagnosis of peripheral artery disease is likely ( 2). Considering this rarity (0.18%), when the dorsalis pedis pulse is absent, we use the pulse of the posterior tibial artery to calculate the ABI. The congenital absence of the dorsalis pedis pulse occurs in only 2% of the normal population when evaluated by Doppler. In such cases, Doppler ultrasound allows the dorsalis pedis pulse to be located with great accuracy. However, in 3.1% to 32.5% of the normal population, the dorsalis pedis artery may not be palpable. After the measurement has been completed, the pulse locations of the lower limbs are found by palpation. We would like to thank Balta and colleagues for their consideration of our article and the editorial board for providing an opportunity to clarify some issues.Īnkle–brachial index (ABI) measurement may be influenced by age, body weight, race and anatomic variations of the lower limb arteries ( 1).
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