A 52-year-old woman comes to the physician for a 6-month history of worsening pain in her legs with exertion. She has no history of trauma. Blood pressure is 140/90. She has smoked one pack of cigarettes daily for the past 20 years. BMI is 35. Physical examination shows loss of hair over the lower legs bilaterally. Which of the following is the most appropriate next step in diagnosis?
Ankle-brachial indices
Arterial calcium score
Arteriography
Venous duplex ultrasonography
Venous plethysmography
