Effect of MDCT angiographic findings on the management of intermittent claudication.
OBJECTIVE
The purpose of this study was to assess the reliability of treatment decisions based on MDCT angiographic findings of stage IIb peripheral arterial occlusive disease (PAOD).


METHODS
Fifty-eight patients with stage IIb PAOD underwent CT angiography of the abdominal aorta and runoff vessels for further treatment planning. Treatment reports, discharge summaries, and follow-up examinations were reviewed to determine the number of treatments correctly planned on the basis of CT angiographic findings.


RESULTS
On the basis of CT angiographic findings, endovascular treatment was indicated for 18 patients, surgical revascularization for nine patients, and a combined endovascular and surgical approach for two patients. Conservative treatment was indicated for 29 patients. On the basis of successful revascularization, the correctness of the treatment decision was confirmed in all but one patient (n = 28). The treatment plan was modified for one patient referred for surgical revascularization. In that patient, stenosis of the common femoral artery had been overlooked on CT angiography. Patients for whom conservative management was indicated on the basis of CT angiographic findings (n = 29) had a mean follow-up period of 501 days without needing revascularization treatment. This result was defined as indirect confirmation of the accuracy of the decision made with CT angiography.


CONCLUSIONS
The findings on MDCT angiography led to correct treatment recommendations for patients with claudication. Thus, CT angiography should be used in the management of PAOD.
Schernthaner
Rüdiger
R
Department of Cardiovascular and Interventional Radiology, Medical University of Vienna, Währinger Gürtel, 18-20, Vienna 1090, Austria. ruediger.schernthaner@meduniwien.ac.at
Fleischmann
Dominik
D
Lomoschitz
Friedrich
F
Stadler
Alfred
A
Lammer
Johannes
J
Loewe
Christian
C
D000368:Aged; D000369:Aged, 80 and over; D000792:Angiography / Q000379:methods*; D005260:Female; D006801:Humans; D007383:Intermittent Claudication / Q000000981:diagnostic imaging* / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D016491:Peripheral Vascular Diseases / Q000000981:diagnostic imaging* / Q000628:therapy*; D011379:Prognosis; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed / Q000295:instrumentation / Q000379:methods*; D016896:Treatment Outcome