Preprocedural imaging: new options to reduce need for contrast angiography.
In vascular surgery, the gold standard for evaluation of the lower-extremity arterial tree has long been contrast arteriography (CA). Associated risks of CA are well-documented and include severe allergic reactions, arterial injury and/or hemorrhage, and contrast-induced nephropathy. Increasingly, less-invasive techniques, with fewer inherent risks for complication, are being explored as diagnostic alternatives. Magnetic resonance angiography, computed tomography angiography, and duplex arteriography, each offer distinct advantages, though are not without limitation. This review explores the indications, advantages, and disadvantages of these newer technologies and provides a comparison to CA as a means for defining the anatomic features of patients undergoing lower-extremity revascularization. This data suggests that noninvasive imaging technologies may, in the future, play an increasingly important role in the surgical evaluation of the patient with lower-extremity ischemia.
Hingorani
Anil
A
Division of Vascular Surgery, Maimonides Medical Center, Brooklyn, NY 11219, USA. ahingorani@maimonidesmed.org
Ascher
Enrico
E
Marks
Natalie
N
D000792:Angiography / Q000009:adverse effects / Q000379:methods; D015901:Angiography, Digital Subtraction / Q000009:adverse effects; D001158:Arteries / Q000473:pathology; D003287:Contrast Media / Q000009:adverse effects; D006801:Humans; D007511:Ischemia / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery; D035002:Lower Extremity / Q000098:blood supply*; D018810:Magnetic Resonance Angiography / Q000009:adverse effects; D018579:Patient Selection; D016491:Peripheral Vascular Diseases / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery; D011300:Preoperative Care; D014057:Tomography, X-Ray Computed / Q000009:adverse effects; D018616:Ultrasonography, Doppler, Duplex / Q000009:adverse effects; D014656:Vascular Surgical Procedures
D003287:Contrast Media