Advanced imaging in limb salvage.
The evaluation of patients at risk for limb loss secondary to peripheral arterial disease begins with a complete history and physical exam, and noninvasive studies in the vascular lab, including duplex ultrasonography. However, successful revascularization depends on high-quality, accurate imaging of the lower extremity vasculature. The traditional gold standard for vascular imaging, digital subtraction angiography, has been improved upon as technologic advances have enabled high-quality alternatives for preoperative (i.e., computed tomography [CT] angiography and magnetic resonance angiography [MRA]) and intraoperative imaging (i.e., intravascular ultrasound [IVUS], cone beam CT, and CO(2) angiography). Here we describe these advanced invasive and noninvasive imaging alternatives and their utility in limb salvage procedures.
Methodist DeBakey Heart & Vascular Center, The Methodist Hospital, Houston, Texas, USA.
Cassidy
C
Duran
Jean
J
Bismuth
D015901:Angiography, Digital Subtraction; D003952:Diagnostic Imaging / Q000379:methods*; D006801:Humans; D007511:Ischemia / Q000175:diagnosis* / Q000601:surgery; D023821:Limb Salvage / Q000379:methods*; D035002:Lower Extremity / Q000098:blood supply*; D018810:Magnetic Resonance Angiography; D011300:Preoperative Care / Q000379:methods*; D018616:Ultrasonography, Doppler, Duplex
Imaging; Limb Salvage; Peripheral Artery Disease