A retrospective review of 101 diabetics without aortoiliac disease was carr
ied out to analyze the ability of various noninvasive tests to predict the
level of significant (>50% stenosis) infrainguinal arterial disease. Patien
ts were studied with anklebrachial indices (ABI), toebrachial indices (TBI)
, segmental pulse volume recordings (PVR), segmental pressures (SEGP), segm
ental Doppler waveforms (DWF), and arteriography. Results were classified a
s normal, disease at the femoropopliteal level, infrapopliteal level, or bo
th levels (multilevel), or noninterpretable. Our findings for the entire st
udy showed that, as a single test, DWF appears to have the best angiographi
c correlation, although the summed diagnosis of combined DWF and PVR data i
s superior in distinguishing multilevel disease from isolated tibial diseas
e. SEGP are of very limited use in diabetics, even in multimodality testing
, and we no longer include that test in our routine evaluation of diabetics
.