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.
Percutaneous bypass graft for severe critical limb ischemia
55 year old female that underwent a skin biopsy with non healing of the biopsy site at 7 weeks.
71 year old female with a non healing ulcer on the left foot.