Patients with peripheral vascular disease (PVD) often have co-existing chronic kidney disease (CKD), making routine contrast use contraindicated due to risk of contrast-induced nephropathy (CIN). Alternative imaging strategies or contrast agents with lower nephrotoxicity should be considered.

This highlights the importance of careful consideration in imaging modalities for patients with PVD and CKD.

Some alternative imaging strategies include:

• Non-contrast CT or MRI
• Ultrasound (Doppler or duplex)
• CO2 angiography
• Gadolinium-enhanced MRI (for selected cases)
• Low-osmolar or iso-osmolar contrast agents