Clinical inquiries: how should you evaluate an asymptomatic patient with a femoral or iliac artery bruit?

Perform an ankle-arm index (AAI, or ankle-brachial index) test to evaluate for peripheral artery disease (PAD) (strength of recommendation [SOR]: B, cohort studies). If the test detects PAD, recommend steps to modify cardiovascular risk factors (SOR: B, extrapolation from randomized clinical trials [RCTs]). Additional vascular diagnostic evaluation is not indicated, because no evidence suggests that proceeding with limb revascularization will improve outcomes in limb pain or function (SOR: C, expert opinion). Not enough evidence exists to recommend routine screening for iliac and femoral arterial bruits. Evidence-based answer