Arterial disorders represent the most common cause of morbidity . Much of this is due to the effects of atheroma on the arteries supplying the heart muscle (coronary thrombosis and myocardial infarction) and brain (stroke), although atheroma is also common at other sites. This clinical condition is typically an Emergency Medicine based diagnosis and the definitive management is the forte of vascular surgeon who also addresses diseases that are typically the province of the vascular surgeon, namely those affecting the peripheral arterial system. Vascular disease that alters the normal structure and function of the aorta, its visceral branches and the arteries of the lower extremity are quite common and often a missed diagnosis or a delayed diagnosis in places with resource limited workforce. Peripheral artery disease (PAD), which typically refers to atherosclerotic arterial disease of the lower extremities, affects more than 200 million people worldwide.1 PAD is considered a clinical manifestation of systemic atherosclerosis and is often present with concomitant coronary artery disease and cerebrovascular disease.2–4 Multiple studies have demonstrated a high risk of major adverse cardiovascular events (MACE), including myocardial infarction, stroke, and cardiovascular death, among patients with PAD.5–7 Beyond cardiovascular outcomes, patients with PAD are also at risk for ischemic limb events which can cause significant morbidity and reduce functional status and quality of life.8–10 In particular, acute limb ischemia (ALI) resulting from a sudden decrease in limb perfusion can lead to tissue loss and threaten limb viability.