ABSTRACT
A 46-year-old white man presents with a 5-year history of progressively worsening, lower extremity claudication. He is now unable to perform his usual daily activities. Physical examination revealed a robust man, 6 foot (1.8 m), and 260 pounds (120 kg). He was obese, with normal blood pressure in both arms and no palpable pulses in either lower extremity. Non-invasive studies revealed an ankle brachial index (ABI) of 0.87 and 0.68 for the right and left legs, respectively.
