Supplementary angiography when lumbar angiograms fail to demonstrate the vessels to the leg.
The peripheral run-off arteries were insufficiently visualized due to occlusions in the aorto-iliac segments in studies of 10 patients (15 legs) in 183 consecutive aorto-femoral angiograms. Guided by a combination of the Doppler technique and fluoroscopy, the non-opacified and pulseless common femoral artery was catheterized. Angiography through this catheter usually showed patency of a part of the common femoral artery but occlusion of the superficial femoral artery. The deep femoral and crural arteries were well preserved. Intra-arterial pressure measurements showed larger pressure gradients along the occluded aorto-iliac segments in one-third of the patients with non-visualized leg arteries as compared with gradients in patients with similar proximal and distal occlusions but with good opacification of the leg arteries. In previous cases, non-visualization of the leg arteries was considered as representing non-reconstructable lesions by our vascular surgeons. The findings in the present study showed that in these patients surgical reconstruction of only the aorto-iliac segments will suffice to save the limb from amputation.
D000792:Angiography / Q000379:methods; D001012:Aorta, Abdominal; D001157:Arterial Occlusive Diseases / Q000000981:diagnostic imaging*; D001794:Blood Pressure; D002404:Catheterization; D004301:Doppler Effect; D005263:Femoral Artery / Q000000981:diagnostic imaging; D005471:Fluoroscopy; D006801:Humans; D007866:Leg / Q000098:blood supply*; D014463:Ultrasonography