Ankle-Brachial Index (ABI) Measurement Periprocedural Care

Updated: Sep 10, 2020
  • Author: Chan W Park, MD, FAAEM; Chief Editor: Karlheinz Peter, MD, PhD  more...
  • Print
Periprocedural Care

Preprocedural Planning

In the clinical setting, the patient should plan on wearing loose-fitting clothes that allow access to the the arms and ankles.



Equipment used in the measurement of the ankle-brachial index (ABI) includes the following:

  • An appropriately sized blood pressure cuff - The width of the cuff should be at least 40% of the limb circumference; a manual blood pressure cuff is preferred, in that it is less prone to error than automatic cuffs are 
  • A Doppler device for detecting flow
  • Ultrasound transmission gel

Patient Preparation


No anesthesia is recommended. Any form of sedative or anesthetic may affect the blood pressure measurement and thus reduce the accuracy of the ABI.


The patient should lie on an examination table in a supine position. The supine position is preferred to the seated position because it relieves the hydrostatic pressure on the extremities by keeping them on the same plane as the heart. [4, 14] ABI results can increase by up to 0.3 if the examination is performed with the patient in a seated position. [6] The patient should rest for at least 10 minutes in the supine position.