Interpreting ABI waveforms

During an automated ankle-brachial index (ABI) test, ABI ratios are calculated and
included in the patient report. While waveforms are only audible when using Doppler
during a manual ABI, an automated ABI machine’s Doppler probe also provides
analog waveforms, which form an important component of the report.

Understanding how to interpret both the audible and analog waveforms of an

automated ABI machine is especially important in circumstances where the ABI
ratios are inaccurate and irrelevant. For example, some vessels are so calcified that
they resist compression and falsely elevate the ABI ratio.

How to position the Doppler probe 

Before we get into how to interpret audible and analog waveforms, let’s review how
to position the Doppler probe when performing an ABI. Pulse sounds (e.g., audible
waveforms) and analog waveforms are qualitative data produced by the Doppler probe.
The sound is crucial, but it is not recorded. Only the analog waveforms are recorded, and
their quality is dependent on the skill of the person using the Doppler probe. 

It is easy to make a healthy vessel look diseased, but it is not easy to make a
diseased vessel look healthy. In other words, audible and analog waveforms may
overestimate the presence of disease if the technique is poor.

Good technique comes with practice and experience. Ideally, the pen is held at 45° (or
less) to the vessel or skin, and is pointed towards the heart. The more perpendicular
you are to the vessel, the more you will overestimate the severity of disease. 

Figure 1. Good technique for a Doppler probe involves holding the pen at 45° or less to the vessel or skin and
pointing towards the heart. 

Become an expert at www.medmastery.com 41