Diagnosis of chronic lower-extremity ischemia

The noninvasive vascular laboratory provides critically important objective and cost-effective information to supplement a careful history and physical examination in the evaluation of patients with CLEI. Optimal cost-effective ordering and interpretation of vascular tests will always depend on a sophisticated knowledge of vascular disease and detailed knowledge of the individual patient. A keen awareness of the limitations of each form of testing and potential sources of error is mandatory. Noninvasive vascular testing allows quantitative, physiologic assessment of lower extremity ischemia and provides the scientific basis for our modern therapeutic approaches to the care of patients with arterial occlusive disease. Clearly, the vascular lab provides much of the objective diagnostic data on which the modern practice of vascular surgery is built.