Letter by Czihal and Hoffmann Regarding Article, “Prevalence of Tibial Artery and Pedal Arch Patency by Angiography in Patients With Critical Limb Ischemia and Noncompressible Ankle Brachial Index”
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To the Editor:
Randhawa et al1 reported on the sensitivity of toe brachial index and pulse volume recordings (PVR) in diagnosing occluded or severely stenotic tibial arteries in patients with a clinical diagnosis of critical limb ischemia (CLI). The authors retrospectively identified 2 cohorts of patients with CLI categorized according to the Rutherford classification (Rutherford class IV–VI) with either compressible or noncompressible tibial arteries as determined by measurement of systolic ankle pressures and ankle brachial index. They compared results of noninvasive testing to angiographic findings and concluded that unlike toe brachial index, PVR is insensitive …