Noninvasive diagnostic strategies for peripheral arterial disease
Susan M. Begelman, MD
Nuvelo, Inc., San Carlos, CA
Michael R. Jaff, DO
Harvard Medical School and Massachusetts General Hospital, Boston, MA
Correspondence: Susan M. Begelman, MD, FACC, Associate Director, Clinical Sciences/Cardiovascular, Nuvelo, Inc., 201 Industrial Road, Suite 310, San Carlos, CA 94070–6211; firstname.lastname@example.org
Dr. Begelman reported that she has no financial relationships that pose a potential conflict of interest with this article.
Dr. Jaff reported that he has received honoraria for teaching and speaking from the Bristol-Myers Squibb/Sanofi Pharmaceuticals Partnership.
At the time this article was written, Dr. Begelman was employed in the Department of Cardiovascular Medicine, Cleveland Clinic, Cleveland, OH.
A variety of diagnostic methods for peripheral arterial disease (PAD) are available, each with strengths and limitations. The ankle-brachial index is a simple and useful screening tool for PAD that can be performed in the office setting. Segmental limb pressure examinations and pulse volume recordings aid in identifying the location of disease. Pulse volume recordings are especially useful, along with the ankle-brachial index, in assessing functional status during exercise. Duplex ultrasonography, magnetic resonance angiography, and computed tomographic angiography are helpful in providing anatomic detail and thus yield additional information for planning interventional therapy. Conventional angiography, the "gold standard" study for PAD diagnosis, is now usually pursued only once an intervention is planned.