Can BlueDop be used as an alternative for diagnosing peripheral arterial disease? A prospective comparison of traditional ABPI and TBPI with BlueDop.

Abstract

ObjectivesAnkle and toe brachial pressure index are recommended globally as first line non-invasive screening tests for peripheral arterial disease. However, they can be inaccurate and have limited utility in patients with incompressible arteries, lower limb wounds and/or lack of digits. This study aims to evaluate BlueDop, a novel device that purports to assess peripheral perfusion without the need for a lower limb tourniquet or patients lying flat.MethodsPatients attending vascular and podiatry clinic at Aneurin Bevan University Health Board were recruited between May 2022 and May 2023. A BlueDop reading was recorded in addition to ankle and/or toe brachial pressure index. Satisfaction and preference of each method was recorded using an electronic proforma.Results176 patients were included. BlueDop ABPI was shown to be moderately correlated with cuff-ABPI (r_s = 0.42, p = .001) and weakly correlated with TBPI (r_s = 0.22, p = .04). BlueDop had moderate accuracy in diagnosing PAD (C statistic = 0.653) and was more accurate in diagnosing severe PAD (C statistic = 0.706). Diagnostic accuracy appeared to be improved when PAD was defined according to cuff-ABPI only. Patients were more satisfied with BlueDop (mean satisfaction score (MSS) = 4.33) compared to cuff-ABPI (MSS = 2.89, mean difference = 0.544, p < .001) and TBPI (MSS = 3.82, mean difference = 0.579, p < .001) while operator satisfaction was equal.ConclusionsThere is moderate correlation between BlueDop and cuff-ABPI. Patients prefer BlueDop to cuff-ABPI or TBPI. BlueDop appears to be an acceptable method of non-invasive assessment of PAD, although users must appreciate there is a discrepancy between it and cuff-ABPI/TBPI.