Which test is commonly used non-invasively to diagnose PVD?

• A. Ankle-Brachial Index (ABI)
• B. Coronary angiography
• C. Echocardiography
• D. TEE

Answer: (A)

Screening for peripheral vascular disease is best done with a simple noninvasive test that directly measures blood flow to the legs. The Ankle-Brachial Index compares the systolic blood pressure in the ankle with that in the arm. If the ratio is reduced (typically less than 0.90), it indicates obstructive disease in the leg arteries consistent with PAD. This test is favored because it is quick, inexpensive, safe, and provides a direct assessment of limb perfusion, helping confirm PAD and stratify its severity for further testing or treatment.

Other options focus on different parts of the circulation or require invasive procedures. Coronary angiography examines the heart’s arteries via catheterization, not the peripheral vessels. Echocardiography and transesophageal echocardiography evaluate heart structure and function, not peripheral arterial disease. Note that in some patients (like those with diabetes and arterial calcification), the ABI can be falsely normal or elevated, in which case alternative tests such as toe-brachial index or vascular imaging may be used.