This review shows that PAD diagnostics are shifting beyond resting ABI toward a multimodal future: post-exercise testing, advanced imaging, biomarkers, and AI repeatedly signal earlier and more precise detection, especially in patients where standard methods fail, such as those with diabetes. Read the full paper to see which emerging tools look truly promising, where the evidence is strongest, and which “innovations” still lack the validation needed for routine practice.
Abstract: The aim of this paper is to systematically review and synthesize the current landscape of diagnostic approaches for peripheral artery disease, identifying emerging technologies and biomarkers that offer enhanced accuracy, sensitivity, and clinical utility. The review utilises 113 original studies with 548377 total participants (topic deduplicated ΣN). This scoping review indicates a broad and rapidly expanding diagnostic landscape for PAD in which newer physiologic testing (notably post-exercise strategies), advanced imaging, circulating/urinary biomarker panels, and AI-enabled analytics recurrently signal improved detection and phenotyping compared with conventional approaches. Across the evidence map, a consistent theme is moving beyond single resting indices toward multi-parameter assessment of perfusion, ischemia, and vascular pathology, with several modalities positioned as non-invasive or point-of-care candidates for earlier identification in higher-risk groups such as people with diabetes. At the same time, interpretation is constrained by substantial heterogeneity in index tests, thresholds, and reference standards and by the absence of formal risk-of-bias appraisal in this scoping design. Clinically, the mapped evidence supports considering stepwise, multimodal diagnostic pathways that combine physiologic testing with targeted imaging and adjunct biomarkers where ABI is limited, while research priorities include standardized thresholds and prospective multicenter validation—particularly for AI models and emerging biomarkers—before routine adoption.
Keywords: Peripheral artery disease diagnosis; Ankle-brachial index; Biomarkers for PAD; Medical imaging diagnostics; Artificial intelligence in diagnosis; Vascular calcification assessment; Ischemia classification; Transcutaneous oxygen pressure; Microvascular disease; Foot-toe glucose index
Review Stats
Final search date and database lock: 2026-03-09 23:19:52 CET
Plan: Pro (expanded craft tokens; source: Semantic Scholar)
Source: Semantic Scholar
Total Abstracts/Papers: 933
Downloaded Abstracts/Papers: 933
Included original and non-original Abstracts/Papers (all): 150
Included original Abstracts/Papers (Vote counting by direction of effect): 113
Reference Index (links used in paper): 75
Total participants (topic deduplicated ΣN): 548377
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