Which test is considered the most definitive for diagnosing peripheral vascular disease (PVD)?

The most definitive test for diagnosing peripheral vascular disease (PVD) is arteriography. This imaging technique involves the use of contrast material and X-rays to visualize the blood vessels. It provides detailed information about the anatomy and patency of the peripheral arteries, showcasing any blockages, stenosis, or abnormalities.

Arteriography is often considered the gold standard because it can directly visualize blood flow and vascular structures, assisting in both diagnosis and guiding potential interventions, such as angioplasty or stent placement. This level of detail makes it superior for confirming the presence and extent of PVD.

Other tests, while useful for initial assessment or screening, do not offer the same level of specificity regarding the vascular structures. For instance, the Ankle-Brachial Index (ABI) is a non-invasive screening tool that compares blood pressures in the ankle and arm but does not provide detailed images of the blood vessels. Doppler Ultrasound can assess blood flow and identify certain abnormalities but lacks the invasive detail that arteriography provides. Magnetic Resonance Angiography (MRA) is non-invasive and can visualize blood vessels using magnetic resonance imaging; however, it may not always be as definitive as arteriography in certain complex cases.

Thus, arteriography