If an ABI reads 1.2 in a patient who is not diabetic and has stiff vessels, what is the most likely explanation?

• A. Technical measurement error
• B. Normal finding
• C. Acute arterial occlusion
• D. Severe claudication

Answer: (A)

ABI values sit on a spectrum where normal perfusion typically falls around 0.9 to 1.3, and arteries that are stiff or calcified can become noncompressible, pushing calculated ankle pressures higher than reality (often yielding ABIs well over 1.3–1.4). When you see a value like 1.2 in a patient who is not diabetic but has stiff vessels, that pattern doesn’t fit the expected artifact from calcification, which would usually push the reading higher. That mismatch points toward a technical measurement issue—something about how the test was performed, such as using an incorrect cuff size, improper Doppler signal, or not capturing true systolic pressures from the correct arteries.

In contrast, an acute arterial occlusion would produce a markedly reduced ABI, and severe claudication generally corresponds to reduced—or at least not clearly normal—ABI values. So the most plausible explanation is a measurement error, and in practice you’d recheck with meticulous technique or consider toe-brachial index if calcification is a concern.