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ABIM Interventional Cardiology study materials
ABIM Interventional Cardiology study resources

ABIM Interventional Cardiology: Peripheral Arterial and Venous Disease and Intervention

ABIM Interventional Cardiology · Work through your exam, one topic at a time.

All guide sections

Peripheral Arterial and Venous Disease and Intervention

Core concepts

Know the ankle-brachial index (ABI) for PAD diagnosis (<0.90 abnormal; >1.3 suggests non-compressible vessels). Understand Rutherford vs. Fontaine classification for limb ischemia. Master endovascular vs. surgical revascularization by anatomy: iliac disease favors stenting; femoropopliteal favors drug-coated balloons/stents; infrapopliteal disease in critical limb ischemia favors angioplasty with limb salvage goals. Know venous disease: DVT management (anticoagulation, catheter-directed thrombolysis for iliofemoral DVT), May-Thurner anatomy, and IVC filter indications (anticoagulation contraindication). Understand access-site and contrast considerations.

Traps

  • Relying on ABI in heavily calcified vessels (falsely normal/elevated).
  • Confusing claudication with critical limb ischemia (rest pain, ulceration, gangrene).
  • Choosing stents in femoropopliteal segments where drug-coated balloons may be preferred.
  • Missing that IVC filters are not a substitute for anticoagulation when anticoagulation is possible.
  • Overlooking compartment syndrome after revascularization.

Rule of thumb

For claudication, start with supervised exercise and medical therapy; intervene for lifestyle-limiting symptoms failing conservative care. For critical limb ischemia, revascularize promptly-limb salvage is the goal.

Worked example

A 70-year-old with rest pain and a non-healing toe ulcer has ABI 0.4. This is critical limb ischemia; proceed to angiography and revascularization rather than exercise therapy.