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Ankle Brachial Index (ABI) Test

The Ankle Brachial Index (ABI) is a powerful, non-invasive test used to diagnosis popliteal artery entrapment syndrome (PAES), external iliac artery entrapment syndrome (EIAE), and peripheral arterial disease.  It is a forgotten test that should be performed in anyone contemplating surgery for Chronic Exertional Compartment Syndrome.

New Jersey Sports Medicine and Performance Center is the only regional center that performs a stress ABI, the Ankle Brachial Index on athletes with treadmill and bicycling provocative measures used to diagnose iliac artery
endofibrosis or iliac artery kinking and popliteal artery entrapment syndrome, two common causes of the often undiagnosed and frustrating condition of exertional leg pain in the athlete.


Dr. Silberman is also the only physician in the region who can perform both exertional compartment testing along with the stress ankle brachial index (ABI) test when evaluating athletes for exertional compartment syndrome.  
Dr. Silberman has diagnosed multiple athletes as having a vascular problem after testing positive for exertional compartment syndrome as well.  Functional popliteal artery entrapment syndrome is treated with botox
injections under ultrasound guidance.  Cost of botox injection for PAES is $500 for each leg (plus cost of medication at the pharmacy).

You don't have to be an athlete to be seen at New Jersey Sports Medicine.   Dr. Silberman specializes in the care of all individuals.

The ankle-brachial index (ABI) is the screening tool of choice in the most recent American College of Cardiology and American Heart Association guidelines for treating PVD.

The ABI test is performed by measuring the blood pressure in your arm and legs simultaneously before and immediately after exercise with evaluation of a wave form of your blood flow.  A slight drop in your ankle
brachial index with exercise or at rest indicates a serious risk factor for heart attack and stroke, irrespective of other risk factors such as smoking or diabetes.

Patients considered for screening are:

Under 50 years old, with diabetes and one other atherosclerosis risk factor (smoking, elevated cholesterol, hypertension or hyperhomocysteinemia)
Age 50 to 69 with history of smoking or diabetes
Age 70 and older
Leg symptoms with exertion (claudication) or ischemic rest pain
Abnormal lower-extremity pulse examination
Known atherosclerotic coronary, carotid or renal artery disease

The PARTNERS study found that the prevalence of PVD in a primary care office diagnosed by the Ankle Brachial Index was 29%, with a suprising 55% of the PVD diagnoses unknown to the patient or the physician, and
less than 10% of PVD patients noting classic symptoms.

The mortality of a patient with an abnormal Ankle Brachial Index (ABI) <.8 is of the same magnitude as some cancers, such as breast and colon cancer, both of which are aggressively screened. In a population of patients older
than 55 with exertional leg pain, the five-year mortality was 30 percent. The majority of this mortality (75 percent) was due to stroke and heart attack, which could have been prevented with lifestyle modification, medication,
and in some cases, surgery.

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