The Association of Cardio-Ankle Vascular Index and Ankle-Brachial Index in Patients with Peripheral Arterial Disease

Introduction: The cardio-ankle vascular index (CAVI) is a well-known index to evaluate arterial stiffness and predict cardiovascular risk. Methods: We investigated whether CAVI can predict severity and extent of peripheral arterial disease. This study was a single-center, retrospective, observational study approved by the Ethics Committee of Yokohama Shintoshi Neurosurgical Hospital. A total of 96 patients (males, 63) with an abnormal ankle-brachial blood pressure index (ABI) of <0.9 and who underwent extremity arteriography at our hospital from 2015 to 2018 were enrolled in this study. We defined that CAVI with a range of <8.0 was normal. Results: Coronary angiography and extremity arteriography were performed for patients who had intermittent claudication and abnormal ABI. We divided the affected limbs into 3 categories: above-the-knee artery stenosis, above-the-knee artery chronic total occlusion, and only below-the-knee artery stenosis/occlusion groups. CAVI pseudonormalization was seen in 28, 76, and 19%, respectively. The above-the-knee artery stenosis and the only below-the-knee artery stenosis/occlusion groups had a high odds ratio of abnormalization of CAVI (3.1, 95% confidence interval [CI]: 1.39–7.22; p = 0.05, 4.56, 95% CI: 1.64–14.7). Discussion/Conclusion: In the presence of the above-the-knee artery chronic total occlusion, CAVI pseudonormalization was likely to be seen. The presence of CTO in the above-the-knee artery is one cause of pseudonormalized CAVI. In the range of ABI, in which stenotic lesions and obstructive lesions coexist, it may be possible to detect the existence of CTO by a combination of both ABI and CAVI.