Noninvasive diagnostic strategies for peripheral arterial disease.

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.