Tables

in Vascular Diagnostics and Imaging

Applied

Type

Modification

Confidence

90%

Created

Mar 20, 2026

Evidence

2 sources

Rationale

The table was updated to integrate the 2025 ACC Scientific Statement on PAD in diabetes, which highlights the critical role of TBI in patients with calcified vessels (diabetes/CKD). Additionally, the narrative review by Raskin et al. (2025) provided a value-based perspective on imaging, leading to the inclusion of 'cost-effective screening' and 'risk of over-utilization' for advanced modalities. Abbreviations were expanded on first use within the table rows as per instructions.

Evidence

Das SR et al. Management of Peripheral Artery Disease in Adults With Diabetes: 2025 ACC Scientific Statement: A Report of the American College of Cardiology. J Am Coll Cardiol. 2025. PMID: 41405527.
Verified source
PubMedDOI
Raskin D et al. A narrative review of imaging misallocation in peripheral artery disease: a value-based medicine perspective. Cardiovasc Diagn Ther. 2025. PMID: 41509627.
Verified source
PubMedDOI

Content Changes

<!-- type: diagnostic -->
**Table 3.1. Comparison of Diagnostic Modalities**

| **Modality** | **Advantages** | **Limitations** | **Main Uses** |
| --- | --- | --- | --- |
| ankle-brachial index (ABI)/toe-brachial index (TBI) | Quick, non-invasive, cheapcost-effective screening | Calcification,Calcification (ABI), less localizinglocalizing; TBI preferred in diabetes/chronic kidney disease (CKD) | peripheral arterial disease (PAD) screening, chronic limb-threatening ischemia (CLTI) |
| Segmental Pressures | Localizes stenosis | Time-consuming | PAD severity |
| TcPO₂ | Predicts wound healing | Operator-dependent | CLTI, wound prognosis |
| DUSduplex ultrasound (DUS) | Portable, repeatable | Operator-dependent | Carotid, venous, grafts |
| computed tomography angiography (CTA) | High-resolution, 3D3D; gold standard for planning | Radiation, contrastcontrast; risk of over-utilization | abdominal aortic aneurysm (AAA), PAD, carotid |
| magnetic resonance angiography (MRA) | No radiationradiation; useful when contrast/radiation contraindicated | Limited availability | Aorta, renal, carotid |
| Angio | Diagnostic + therapeutic | Invasive | Final planning, intervention |
| IVUS/OCTintravascular ultrasound (IVUS)/optical coherence tomography (OCT) | High precision | Cost, availability | Endovascular optimization |
| PET/CTpositron emission tomography/computed tomography (PET/CT) | Functional info | Expensive, research | Vasculitis, infection | [@aboyans2012] [@potier2011] [@schepers2010] [@moneta2010] [@sru2003] [@sun2011] [@prince2016] [@ali2016] [@slart2018] [@esvs2019-aaa] [@esvs2018-esvs] [@svs2018] [@aha2016] [@acc2025-i] [@raskin2025-narrative]
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