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Table 1. Diagnosis of Peripheral Arterial Disease (PAD)
Recommendations Grade
Level of
Evidence
The SVS recommends using the ABI as the first-line
noninvasive test to establish a diagnosis of PAD in
individuals with symptoms or signs suggestive of disease.
When the ABI is borderline or normal (>0.9) and symptoms
of claudication are suggestive, the SVS recommends an
exercise ABI.
1 A
The SVS suggests against routine screening for lower
extremity PAD in the absence of risk factors, history, signs,
or symptoms of PAD.
2 A
For asymptomatic individuals who are at elevated risk,
such as those aged >70, smokers, diabetic patients, those
with an abnormal pulse examination, or other established
cardiovascular disease, screening for lower extremity PAD is
reasonable if used to improve risk stratification, preventive
care, and medical management.
2 A
In symptomatic patients who are being considered for
revascularization, the SVS suggests using physiologic
noninvasive studies, such as segmental pressures and pulse
volume recordings, to aid in the quantification of arterial
insufficiency and help localize the level of obstruction.
2 A
In symptomatic patients in whom revascularization
treatment is being considered, the SVS recommends
anatomic imaging studies, such as arterial duplex ultrasound,
computed tomography angiography, magnetic resonance
angiography, and contrast arteriography.
1 B
