title: Accuracy of DSA in the evaluation of patency of infrapopliteal vessels.
abstract: OBJECTIVE
  To evaluate the accuracy of intraarterial digital subtraction angiography (DSA) in the demonstration of patent infrapopliteal vessels.
  
  
  METHODS
  One-hundred sixty-five arteriograms were obtained in 153 consecutive patients prospectively enrolled to evaluate lower extremity ischemia. In 86 cases a follow-up angiogram of the infrapopliteal vessels was obtained during surgery or after endovascular intervention (n = 57). Twenty-nine arteriograms were followed by surgical exploration of the infrapopliteal vessels. Standard angiographic technique was performed with intraarterial DSA of the most symptomatic foot. Visualization of distal vessels was compared with intraoperative or postintervention imaging or with the results of surgical exploration.
  
  
  RESULTS
  Of the 57 procedures after which either intraoperative or post-endovascular intervention angiography was performed, DSA results were equivalent in 47 (82%) and worse in five (9%). When individual vessels were evaluated, the sensitivity of DSA in the identification of patent named vessels was 95%, and the specificity was 92%. Among 29 cases with a surgical standard of reference, 28 patients underwent bypass to a vessel correctly identified as patent at DSA; one patient was incorrectly identified as having no patent named vessels.
  
  
  CONCLUSIONS
  Intraarterial DSA is accurate and reliable in the assessment of patency in infrapopliteal vessels before surgery or endovascular intervention in patients with infrainguinal atherosclerotic disease.
authors.affiliation: Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis, MO 63110, USA.
authors.forename: R F
authors.initials: RF
authors.lastname: Oser
authors.forename: D
authors.initials: D
authors.lastname: Picus
authors.forename: M E
authors.initials: ME
authors.lastname: Hicks
authors.forename: M D
authors.initials: MD
authors.lastname: Darcy
authors.forename: D M
authors.initials: DM
authors.lastname: Hovsepian
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000792:Angiography; D015901:Angiography, Digital Subtraction; D005260:Female; D006801:Humans; D007511:Ischemia / Q000000981:diagnostic imaging / Q000628:therapy; D007866:Leg / Q000098:blood supply*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012680:Sensitivity and Specificity; D014654:Vascular Patency