title: Has arteriography gotten a bad name? Current accuracy and morbidity of diagnostic contrast arteriography for aortoiliac and lower extremity arterial disease.
abstract: Recently, contrast arteriography has been challenged as the diagnostic test of choice for lower extremity arterial disease because of its associated morbidity and questionable accuracy in identifying suitable distal outflow arteries. The purpose of this report was to analyze our experience to determine if these concerns were justified. We reviewed 500 consecutive contrast arteriograms performed at our hospital for aortoiliac and lower extremity arterial disease between November 1994 and November 1998. Arteriograms performed in conjunction with therapeutic procedures such as balloon angioplasty, stent placement, and thrombolysis were excluded, leaving 244 diagnostic cases for analysis. Forty-six percent (112) of patients had diabetes mellitus, 14% (34) had an elevated baseline serum creatinine (> or =1.5 mg/dL), and an additional 7% (17) were dialysis dependent. Radiologists limited contrast volume by imaging only the symptomatic extremity when appropriate and using digital subtraction techniques as indicated. Our results showed that diagnostic contrast arteriography is associated with an acceptably low morbidity, has an accuracy that is unlikely to be surpassed by other modalities, and remains the diagnostic test of choice for lower extremity arterial disease.
authors.affiliation: Section of Vascular Surgery, Pennsylvania Hospital, Philadelphia 19106, USA.
authors.forename: N
authors.initials: N
authors.lastname: Schindler
authors.forename: K D
authors.initials: KD
authors.lastname: Calligaro
authors.forename: J
authors.initials: J
authors.lastname: Lombardi
authors.forename: M J
authors.initials: MJ
authors.lastname: Dougherty
authors.forename: C A
authors.initials: CA
authors.lastname: Raviola
authors.forename: E
authors.initials: E
authors.lastname: D'Orazio
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000792:Angiography / Q000379:methods; D001027:Aortography; D001157:Arterial Occlusive Diseases / Q000175:diagnosis* / Q000453:epidemiology; D003404:Creatinine / Q000097:blood; D003949:Diagnostic Techniques, Surgical; D005260:Female; D005263:Femoral Artery / Q000000981:diagnostic imaging; D006801:Humans; D007083:Iliac Artery / Q000000981:diagnostic imaging; D007866:Leg / Q000098:blood supply / Q000000981:diagnostic imaging*; D008297:Male; D008875:Middle Aged; D009017:Morbidity; D010414:Pennsylvania / Q000453:epidemiology; D012077:Renal Artery / Q000000981:diagnostic imaging; D012189:Retrospective Studies
chemical_list: D003404:Creatinine