3
Diagnosis
Figure 1. Flow diagram for the investigation of patients
presenting with suspected CLTI
Clinical suspicion of CLTI
Rest pain - Tissue loss
Search for alternative
diagnosis
ABI >1.40 or
discordant ankle
pressure, ABI, and/or
Doppler waveforms
Normal ABI
(0.90–1.40)
Abnormal ABI <0.90
Measure toe pressure,
TBI, and Doppler
waveforms
Stage limb severity
(WIfI)
Search for alternate
cause of rest pain
Obtain vascular imaging
if patient is a candidate
for revascularization
NO
NO
YES
Tissue loss or
gangrene
YES
Measure ankle pressure,
ABI, and Doppler
waveforms
Complete physical exam
suggestive of PAD
