Q. How is it possible that my ABI is 1.27 when I can literally see the tibial pulse in both feet with feet raised? I have pedal oedema due to venous reflux.

Doctor Answer is medically reviewed by SecondMedic medical review team.

Answered by Secondmedic Expert

ABI (Ankle-Brachial Index) is a non-invasive measurement used to diagnose peripheral artery disease by comparing the blood pressure in your ankle with that of your arm. A “normal” ABI reading is between 0.9 and 1.3, so it does seem strange that your reading would be 1.27 when you can feel the tibial pulse in both feet – this indicates sufficient circulation!

There are two possible explanations for why your ABI wouldn't reflect what you see with the naked eye:
1) Your arteries may not be as healthy as they appear—the pulse could still be detectable, but weak enough for an abnormal ABI result because of plaque or inflammation build up on the walls of the artery;
2) There could also be venous reflux present which is dilating veins resulting in increased pressures throughout venous system - although pedal oedema due to reflux has been identified, there can sometimes still remain poor arterial flow exhibiting higher than usual pressures at rest leading to an increase in readings despite visible pulses via palpation/auscultation.
Either way, if you have a weak tibial pulse detected by physical examination combined with an elevated ABI result (1.27), then it would suggest further testing should be done to assess potential vascular health issues and confirm whether or not these symptoms are related to potential underlying medical conditions such as critical limb ischemia, diabetes-related arteriosclerosis or deep vein thrombosis etc.