Diagnosis of peripheral arterial disease: utility of the vascular laboratory.

The risks of undiagnosed peripheral arterial disease (PAD) include progressive reduction in quality of life, potential limb loss, and unrecognized comorbid atherosclerotic (concomitant coronary and cerebrovascular) disease. Although a thorough historical review of symptoms and a comprehensive physical examination may lead the clinician to an appropriate index of suspicion, accurate diagnostic testing is crucial. Accredited vascular diagnostic laboratories provide a risk-free description of the presence, severity, and location of PAD. This article describes the basic noninvasive diagnostic tests, criteria for diagnosis, advantages and disadvantages of each diagnostic modality, and a strategy for PAD therapy.