Comparison of computed tomography angiography to contrast arteriography for patients undergoing evaluation for lower extremity revascularization.
In an effort to explore alternatives to contrast arteriography, we compared computed tomography angiography to contrast arteriography for defining anatomic features of patients undergoing lower extremity revascularization. From November 2003 to March 2004, 36 inpatients with chronic lower extremity ischemia underwent contrast arteriography and computed tomography angiography before undergoing lower extremity revascularization procedures. A Siemens 16 slice multiplanar computed tomography device with bolus tracking was used for these exams. The reports of these tests and images were compared prospectively, and the differences in the aorto-iliac segment, femoral-popliteal, and infrapopliteal segments were noted. The vessels were classified as mild disease (<50%), moderate disease (50%-70%), severe (71%-99%), and occluded. The studies and treatment plans based on these data were compared. The mean age was 76 +/- 12 years (SD). Indications for the procedures included gangrene (45%), ischemic ulcer (32%), rest pain (19%), and severe claudication (3%); 69% were diabetics. Accuracy of computed tomography angiography in the aorto-iliac, femoral-popliteal, and infrapopliteal segments was 100%, 81%, and 59%, respectively. Thirteen of 18 (72%) of these disagreements resulted in a different procedure than that suggested by computed tomography angiography. A review of the data obtained in this series indicated that computed tomography angiography appears to be unable to obtain adequate information in this highly selected population at our institution.
Hingorani
Anil
A
Division of Vascular Surgery, Department of Surgery, Mainmonides Medcine Center, Brooklyn, New York 11219, USA.
Ascher
Enrico
E
Marks
Natalie
N
Mutyala
Manykiam
M
Shiferson
Alexander
A
Flyer
Mark
M
Jacob
Theresa
T
D000368:Aged; D000369:Aged, 80 and over; D015901:Angiography, Digital Subtraction / Q000379:methods; D001011:Aorta / Q000473:pathology / Q000601:surgery; D002908:Chronic Disease; D003287:Contrast Media; D005263:Femoral Artery / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery; D005734:Gangrene / Q000000981:diagnostic imaging / Q000209:etiology / Q000601:surgery; D006801:Humans; D007083:Iliac Artery / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery; D007383:Intermittent Claudication / Q000000981:diagnostic imaging / Q000209:etiology / Q000601:surgery; D007511:Ischemia / Q000150:complications / Q000000981:diagnostic imaging* / Q000601:surgery*; D007871:Leg Ulcer / Q000000981:diagnostic imaging / Q000209:etiology / Q000601:surgery; D035002:Lower Extremity / Q000098:blood supply* / Q000000981:diagnostic imaging*; D008875:Middle Aged; D011150:Popliteal Artery / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index; D014057:Tomography, X-Ray Computed / Q000379:methods; D016896:Treatment Outcome; D014656:Vascular Surgical Procedures
D003287:Contrast Media