Exams and Tests

Anyone with symptoms or signs of peripheral artery disease (PAD) should be tested. Some people should be screened for PAD even in the absence of symptoms or signs, such as individuals older than 65 or if you have:

• Other risk factors for atherosclerosis such as diabetes, smoking history, high cholesterol, or high blood pressure
• Family history of PAD
• Other artery disease, for example coronary artery disease, renal artery disease, or subclavian artery disease

The diagnosis of PAD begins with a simple exam by your clinician or podiatrist. They will look at the skin on your legs and feet for color changes, ulcers, or wounds that may be slow to heal. They will feel the temperature of your skin and check the pulses in your legs and feet.

Your clinician will also ask you questions about how active you are able to be and if you have slowed down for any reason. Your medical record will be reviewed to assess other risk factors you have for PAD.

Blood tests looking for signs of diabetes, kidney disease and high cholesterol may be done.

If your doctor suspects you have PAD, then they will likely arrange for you to have an Ankle-Brachial Index test (ABI). This is a simple test that can be done in the office to check circulation in the legs. It consists of taking blood pressure in the arms and at the ankles with an ultrasound probe. The exam takes about 10 minutes, and you will be asked to lie down flat. After the two blood pressure readings, a ratio is calculated to get the value of your ABI.

An ABI of 0.90 or less is considered a sign of PAD. An ABI of greater than 1.3 may signal stiff arteries that may or may not be blocked.

In some cases, a computed tomography (CT) scan or magnetic resonance imaging (MRI) scan may be required – usually if after the ABI test or ultrasound test more information is needed or to guide the best treatment options.

Finally, you may have an invasive catheter angiogram that can serve as both a test and a treatment. This procedure involves injecting dye into the affected arteries and taking X-ray images to see where blockages may be. If blockages are found, your clinician may open up these arteries during the procedure. They can use a device to cut, drill or shave through the plaque to allow more blood to flow through.