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.
Current physiologic testing for ulcer perfusion may fail to identify patients with ischemia
A faster technique for embolization gonadal veins using large diameter coils
65 year old cyclist with extensive superficial and deep venous incompetence and venous ulceration