The TBI Package adds value to the Portable ABI kit by providing a means of performing Toe Brachial Indexes for patients who have calcified ankle/leg blood vessels, often due to diabetes. The Toe Brachial Index Package provides the instruments and accessories to facilitate a TBI for patients presenting with diabetes and PAD with calcified vessels, who have an abnormally high ABI (over 1.3.) This makes it easy for a primary care physician, home health nurse or other care giver to complete the initial screening for PAD for those patients and to obtain an accurate assessment of their risk before referring the patient to a vascular specialist.