An ABI value of 1.6 is most consistent with which finding?

• A. Normal arterial status.
• B. Mild PAD.
• C. Severe PAD.
• D. Noncompressible arteries due to calcification.

Answer: (D)

An ABI well above normal usually means the arteries in the ankles are not compressible because of calcification, not that blood flow is exceptionally good. Normal ABI ranges from about 1.0 to 1.4; values higher than that suggest arterial stiffness from medial calcification (Monckeberg sclerosis), which often occurs with diabetes and chronic kidney disease. When the arteries are calcified, they don’t compress properly under the cuff, so the ankle systolic pressure appears falsely high, yielding a value like 1.6. This is why the finding described is noncompressible arteries due to calcification. In contrast, PAD typically lowers the ABI, and a normal-appearing 1.0–1.4 would not explain such a high number; for calcified arteries, alternative testing like toe-brachial index is often used because toe vessels are less affected by calcification.