[Rotational angiography of the femoropopliteal arteries after percutaneous transluminal angioplasty: technical aspects and preliminary results].
OBJECTIVE
The angiographic evaluation of the results of femoropopliteal balloon angioplasty (PTA) is fundamental for monitoring long term success, but, often, the examination is performed only with one or two orthogonal projections. The aim of this study is to report our experience with a new digital angiography system able to perform "rotational" acquisitions to assess the results after femoro-popliteal PTA.


METHODS
Twenty-eight patients underwent femoro-popliteal PTA due to steno-obstructive lesions varying in length between 1 and 10 cm. All examinations were performed on a Philips Integris Allura system able to perform "rotational angiography"(RA). The two frames showing the greatest degree of stenosis and the presence of subintimal "flaps" induced by PTA were compared with the frame obtained in the AP projection.


RESULTS
RA after PTA was possible in all cases. In 12/28 (42.4%) cases there was no difference between the static AP projection and RA, whereas in 13/28 (46.5%) the static acquisition, compared with RA, underestimated the extent of residual stenosis by 10-30%. In 6 out of these 13 cases a discordance on the presence and extent of subintimal flap between static and rotational acquisition was identified. In three other cases (10.7%) there was substantial agreement on the residual stenosis but not on the PTA-induced dissection which was always better visible on RA.


CONCLUSIONS
RA allowed optimal analyses of all cases improving the information of the conventional technique based on one projection only. It also proved very useful in demonstrating residual stenosis and PTA-induced dissections. In our experience this information modified our therapeutic approach leading to repeated balloon angioplasty or stenting in about 50% of cases.
Pozzi Mucelli
Fabio
F
Unità Clinico Operativa di Radiologia, Università degli Studi, Trieste. pozzi-mucelli@libero.it
Latini
Isabella
I
Dibilio
Daniela
D
Pozzi Mucelli
Roberto
R
D000368:Aged; D000369:Aged, 80 and over; D000792:Angiography / Q000379:methods*; D000800:Angioplasty, Balloon; D001157:Arterial Occlusive Diseases / Q000000981:diagnostic imaging / Q000628:therapy*; D003287:Contrast Media; D005260:Female; D005263:Femoral Artery; D006801:Humans; D008297:Male; D008875:Middle Aged; D011150:Popliteal Artery; D016896:Treatment Outcome
D003287:Contrast Media