Background

Rationale

The existing citation Patel MR, et al refers to an older AHA guideline that has been explicitly superseded by the 2024 ACC/AHA lower extremity peripheral artery disease (PAD) guideline. Per the stale guideline replacement instructions, the stale citation is replaced with AHA for the same general claim about adherence to evidence-based guidelines from major vascular societies. No other content changes are warranted, as the Background section is a high-level summary and the new guideline supports the same claim without requiring additional textual modification.

Evidence

Content Changes

**Summary:** This chapter provides a comprehensive overview of diagnostic modalities in vascular surgery, ranging from bedside clinical examination to advanced imaging techniques and emerging artificial intelligence (AI) applications. The diagnostic approach must balance accuracy, safety, cost-effectiveness, and availability while adhering to evidence-based guidelines from major vascular societies. [@rutherford2018-rutherford] [@aha2016][@svs2024-gornik] [@esvs2024-editors] [@eur2020] [@svs2024-n]