Diagnostic Testing

ABI-TBI Exam | PVR Exam | TCPO2 Exam | Vascular Doppler Ultrasound Test

ABI-TBI Exam

The Ankle Brachial Index (ABI) and Toe Brachial Index (TBI) are non-invasive diagnostic tests that evaluate circulation in the lower limbs and aid in the detection of peripheral artery disease (PAD). These tests measure and compare blood pressure at various locations in the limbs to assess arterial function and identify potential narrowing or blockages within the arteries.

How do the ABI and TBI Exams work?

During an ABI exam, blood pressure cuffs are placed on the arms and ankles. A Doppler ultrasound device is used to listen to blood flow and measure systolic blood pressure at each location. The ankle pressure is then compared to the arm pressure to calculate the ABI value.

In a TBI exam, small cuffs are placed around the toes instead of the ankles. Because toe arteries are less affected by arterial calcification, the TBI test is especially useful for patients with diabetes, kidney disease or conditions that can make ABI results less reliable. Toe systolic pressure is measured and compared to the brachial pressure in the arm to calculate the TBI value.

PVR Exam

PVR stands for pulse volume recording. It is a non-invasive vascular test used to evaluate blood flow in the arteries of the legs. It helps diagnose peripheral artery disease by measuring changes in blood volume within the limbs during each heartbeat.

How does the PVR exam work?

During the exam, blood pressure cuffs are placed at different levels along the legs, such as the thighs, calves, ankles or toes. The cuffs are inflated slightly to detect pulse waveforms created by blood flowing through the arteries. These waveforms are recorded and analyzed to determine whether blood flow is normal or reduced due to narrowing or blockages in the arteries.

Unlike the ABI test, which relies on blood pressure ratios, a PVR exam evaluates the shape and strength of pulse waveforms. This makes it particularly useful for patients with calcified or non-compressible arteries, such as those with diabetes or chronic kidney disease, where ABI results may be less accurate.

PVR testing is often performed alongside ABI or TBI exams to provide a more complete assessment of lower-extremity circulation.

TCPO2 Exam

A Transcutaneous Oxygen Measurement (TcPO2) exam is a non-invasive test used to assess the amount of oxygen reaching the skin and underlying tissues. It helps doctors evaluate circulation and tissue perfusion, particularly in patients with peripheral artery disease, chronic wounds, diabetes or limb-threatening ischemia.

How does a TCPO2 exam work?

During the exam, small sensors are placed on the skin, usually on the legs or feet. These sensors gently heat the skin to increase local blood flow and measure the oxygen level diffusing through the skin from the capillaries. The recorded oxygen values reflect how effectively blood and oxygen are being delivered to the tissues.

Lower TcPO2 readings may indicate poor circulation, impaired wound-healing potential or severe arterial disease. The test is commonly used to:

Assess wound-healing capability
Evaluate the severity of PAD
Determine the need for revascularization procedures
Predict healing outcomes after amputation or surgery
Monitor tissue oxygenation over time

The TcPO2 exam is painless, does not involve needles or radiation and typically takes 30 to 60 minutes depending on the number of sites being tested. It is often performed alongside other vascular studies, such as ABI, TBI or PVR testing, to provide a more comprehensive evaluation of lower-extremity circulation and tissue health.

Vascular Doppler Ultrasound Test

A vascular ultrasound Doppler test is a non-invasive imaging exam used to evaluate blood flow through the arteries and veins. It combines traditional ultrasound imaging with Doppler technology to assess how blood moves through the blood vessels and to detect circulatory problems.

How does a vascular ultrasound Doppler test work?

During the test, a trained technologist applies gel to the skin and moves a handheld device called a transducer over the area being examined. The transducer uses sound waves to create images of the blood vessels and measure the speed and direction of blood flow. Doppler technology detects changes in sound wave frequency caused by moving blood cells, allowing providers to identify abnormal circulation patterns.

This test is commonly used to:

Detect narrowed or blocked arteries
Diagnose peripheral artery disease (PAD)
Identify blood clots, such as deep vein thrombosis (DVT)
Evaluate varicose veins or venous insufficiency
Monitor blood flow after vascular procedures or surgery
Assess aneurysms or carotid artery disease

A vascular Doppler ultrasound is painless, does not use radiation and is typically completed within 30 to 60 minutes. It provides valuable information about vascular health and is often used alongside other vascular studies, such as ABI, TBI, PVR or TcPO2 testing, to help diagnose and monitor circulatory conditions.

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