Referred by a haematologist for bilateral leg artery ultrasound to investigate compromised blood supply. The patient stated he had claudication after 10 minutes of walking. The patient was an ex-smoker and had hypertension, which was medically controlled. He had smoked for more than 40 years. Specialist determined ankle-brachial index and aorto-iliac ultrasound assessment were also performed.
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Low-grade >75% stenoses at the aortic bifurcation with velocities indicating slightly more advanced disease on the right. This finding, in conjuntion with mild-to-moderate tibial artery disease may explain the patient's abnormal ABI results and clinical symptoms.
Predominant disease at the aorto-iliac level is seen in 25% of patients.
Given the subsequent findings, an exercise ABI or toe photoplethysmography study would likely have revealed that the disease on the left was more severe than indicated by the resting study.