Ask about leg fatigue, pain or numbness with ambulation, impotence, and nonhealing leg foot ulcers.
Look for absent pedal pulses, bruits, and ulcers between or on the tips of toes, especially with pale or irregular borders.
Use the resting ABI to establish the diagnosis of lower extremity PAD in patients with resting ABI <0.90.
Obtain an exercise or stress ABI in patients with history consistent with claudication but an ABI >0.90.
Obtain digital subtraction arteriography in patients with indications for an intervention, using magnetic resonance arteriography as an alternative test in patients at high risk for contrast nephropathy or contrast allergy.
Diagnose acute limb ischemia with the six P's: pain, poikilothermia, pulselessness, paralysis, paresthesias, pallor.