The systolic blood pressure in the great or other toe can be measured with the correct equipment. It can give insights into the perfusion of the lower extremity.
Measurement:
(1) small cuff designed for toes
(2) method to detect blood flow such as photoplethysmography or Doppler ultrasonography
Parameters:
(1) systolic pressure in the toe in mm Hg
(2) systolic pressure in the brachial artery in mm Hg (higher of left or right)
toe to brachial index =
= (systolic blood pressure at the toe in mm Hg) / (systolic blood pressure at the brachial artery in mm Hg)
Interpretation:
• A systolic toe pressure < 95.5 mm Hg is seen in peripheral arterial disease.
• A toe to brachial index < 0.7 is seen in peripheral arterial disease.
• A toe to brachial index < 0.6 is associated with need for a vascular intervention.
Ankle-Brachial Index
Toe-Brachial Index
6-Year Survival
> 0.9
> 0.6
69%
> 0.9
<= 0.6
43%
<= 0.9
NA
21%
Figure 3 Hishida et al
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