Which test is considered the most definitive for diagnosing Peripheral Artery Disease (PAD)?

The most definitive test for diagnosing Peripheral Artery Disease (PAD) is arteriography, also known as angiography. This procedure involves the use of imaging techniques to visualize the blood vessels and can identify blockages or narrowing of the arteries due to atherosclerosis. During arteriography, a contrast dye is injected into the blood vessels, and images are taken using X-ray technology, which allows for precise visualization of arterial anatomy and blood flow. This helps confirm the presence and extent of PAD, making it a reliable diagnostic tool.

While the Ankle-Brachial Index (ABI) is a useful initial screening test for PAD and helps in assessing blood flow, it is not as definitive as arteriography. ABI provides a ratio of blood pressure measurements at the ankle compared to the arm and can indicate possible arterial disease, but it does not provide detailed anatomical information about the arteries.

Pulse checks and Magnetic Resonance Angiography (MRA) are also valuable in evaluating vascular function and structure. Pulse checks can provide basic information about circulation to the limbs but lack the specificity needed for a definitive diagnosis. MRA can visualize blood vessels similarly to arteriography, but it may not be as widely used or available as arteriography for definitive assessments.