Which of the following symptoms is least likely to indicate vascular disease?

Claudication with consistent pain typically indicates a vascular issue, particularly peripheral artery disease (PAD), where insufficient blood flow leads to pain during physical activity. This choice is indicative of vascular disease because the pain experienced is consistent with muscle ischemia during exertion due to narrowed or blocked arteries.

In contrast, calf and thigh pain that resolves with rest suggests a temporary reduction in blood flow, common in claudication cases but further emphasizes the intermittent nature, which aligns with vascular diseases. Similarly, pain that occurs after walking a short distance is a classic symptom of claudication, reinforcing the association with vascular issues as it reflects an inability of the vascular system to meet the increased demands of the muscles during exercise.

Extreme muscle fatigue during prolonged walking can be a symptom of various conditions, not solely vascular disease, as it could relate to muscular, neurological, or metabolic factors as well. Thus, while it's symptomatic of some issues that might suggest vascular involvement, it is less specific compared to the other choices.

Therefore, A is a symptom that strongly indicates vascular disease, making it the least likely incorrect response when focusing on the kind of pain and its implications within the context of vascular health.