Ankle–brachial pressure index grossly overestimate the ABI (by approximately 0.3). A Doppler ultrasound blood flow detector, commonly called Doppler wand or Doppler probe, and a sphygmomanometer (blood pressure cuff) are usually needed. The blood pressure cuff is inflated proximal to the artery in question. Measured by the Doppler wand, the inflation continues until the pulse in the artery ceases. The blood pressure cuff is then slowly deflated. When the artery's pulse is re-detected through the Doppler probe the pressure in the cuff at that moment indicates the systolic pressure of that artery. The higher systolic reading of the left and right arm brachial
Perforating branches of internal thoracic artery Perforating branches of internal thoracic artery The perforating branches of the internal thoracic artery pierce through the internal intercostal muscles of the superior six intercostal spaces. These small arteries run with the anterior cutaneous branches of the intercostal nerves. The perforating arteries constitute part of the blood supply to the pectoralis major and the overlying tissue and skin. The second, third and fourth perforating branches give off medial mammary branches, which become enlarged during lactation. Chung, Kyung Wong, Ph.D. "Board Review Series: Gross Anatomy, 3rd ed. 114-115. Williams and Wilkins: 1995." Lockhart, R.D., et al. "Anatomy of the Human Body."