Non-invasive bedside testing — ABI, TBI, and Doppler — to confirm adequate blood flow before treatment.
Healix360 supports access to advanced mobile wound care services for patients throughout our coverage area. Services are delivered by licensed physicians and nurse practitioners experienced in the evaluation and management of chronic and complex wounds. Care is coordinated and provided directly to patients in private residences, assisted living communities, and skilled nursing facilities. Vascular assessment works by combining clinical examination with objective hemodynamic measurements. ABI compares blood pressure at the ankle with blood pressure at the arm to estimate the severity of any arterial obstruction. TBI is used in patients with calcified non-compressible vessels (common in diabetes) where ABI is unreliable. Doppler ultrasound provides an audible and waveform readout of arterial flow at specific points along the leg and foot. Together, these data points determine whether a wound has the perfusion required to heal — and whether vascular surgery referral is warranted before further wound care is escalated.
A licensed clinician determines whether this treatment is appropriate after evaluating the wound and the patient's medical history.
Treatment decisions are individualized. Potential contraindications and precautions may include:
The clinician brings a portable Doppler unit and pressure cuffs to the bedside. After a brief rest period, blood pressure is measured at the brachial artery, the dorsalis pedis, and the posterior tibial artery (and at the great toe if TBI is needed). The full assessment typically takes 15 to 25 minutes and is comfortable for the patient. Results are documented in the visit note alongside a clinical interpretation and a clear recommendation regarding vascular referral if needed.
Society for Vascular Surgery guidelines, the International Working Group on the Diabetic Foot, and Wound Healing Society standards all recommend non-invasive vascular assessment as a foundational step in the evaluation of any lower-extremity ulcer. ABI and TBI measurements are well-validated predictors of healing potential and amputation risk.
No. The assessment is non-invasive. The clinician inflates a blood pressure cuff briefly at the arm and ankle, similar to a routine blood pressure check, while listening with a small handheld Doppler probe.
Diabetes can cause calcification of the medial layer of the larger leg arteries, making them resistant to compression. This produces a falsely elevated ABI. Toe arteries are less commonly calcified, so the toe-brachial index gives a more accurate picture of perfusion in diabetic patients.
An abnormal result prompts a referral to vascular surgery for further imaging and consideration of revascularization. Restoring blood flow is often the single most important step before any other wound therapy will be effective.
No. Applying compression to a leg with significant arterial disease can worsen ischemia and cause serious harm. A vascular assessment is performed before any compression therapy is initiated for a venous leg ulcer.
Non-invasive vascular studies performed by a licensed clinician are typically covered by Medicare Part B, Medicare Advantage, Medicaid, and most commercial plans when medical necessity is documented.
Call 877-545-1300 or request a provider to begin care. Healix360 serves Southern California and Nevada and accepts Medicare Part B and most major insurance plans.