The clinical evaluation of peripheral arterial disease (PAD) is difficult and yet critically important so that patients receive the care they need. The greatest problem is that clinical evaluation is limited in excluding significant PAD. In short, none of the various clinical findings have a high negative predictive value for PAD. Even simple pulse palpation is fraught with error. All patients with non healing ulcers or wounds or with exertional leg pain should undergo objective physiologic testing.
Recurrent lower extermity DVT should prompt an investigation for venous outflow obstruction. Too often these patients are under treated.
87 year old male with a right groin pseudoaneurysm due to the dehisences of the fabric of an aorto bifemoral bypass graft
36 year old with pelvic aching and heaviness, painful intercourse and urinary frequency treated with the "uncoil coil" technique