DSA versus multi-detector row CT angiography in peripheral arterial disease: randomized controlled trial
Marc C J M Kock1, Miraude E A P M Adriaensen, Peter M T Pattynama
1Program for the Assessment of Radiological Technology, Erasmus Medical Center, 3015 GE Rotterdam, the Netherlands.
Radiology
|October 26, 2005
Summary
Multi-detector row CT angiography is a cost-effective alternative to digital subtraction angiography for diagnosing peripheral arterial disease, offering comparable patient outcomes and reducing imaging costs.
Area of Science:
- Vascular Imaging
- Medical Diagnostics
- Health Economics
Background:
- Peripheral arterial disease (PAD) diagnosis relies on imaging techniques.
- Digital subtraction angiography (DSA) and multi-detector row computed tomographic (CT) angiography are used for initial PAD diagnosis.
- Comparing these modalities is crucial for optimizing patient care and resource allocation.
Purpose of the Study:
- To prospectively compare therapeutic confidence, patient quality of life, and costs between DSA and multi-detector row CT angiography for initial PAD diagnosis.
- To evaluate the impact of imaging choice on subsequent diagnostic and therapeutic decisions.
Main Methods:
- 145 patients with PAD were randomized to undergo either DSA or multi-detector row CT angiography.
- Outcomes assessed included physician confidence, need for additional imaging, quality of life at 6-month follow-up, and diagnostic/therapeutic costs.
- Statistical analysis involved unpaired t-tests and multivariable regression.
Main Results:
- Physician confidence was significantly higher with DSA (8.2) than CT angiography (7.2; P < .001).
- No significant differences in quality of life or need for additional imaging were observed between groups.
- Diagnostic costs were significantly lower for CT angiography (€363) compared to DSA (€564; P < .001).
Conclusions:
- Multi-detector row CT angiography provides sufficient information for therapeutic decision-making in PAD.
- Noninvasive CT angiography is a cost-effective alternative to DSA for initial PAD diagnosis.
- This suggests a shift towards noninvasive imaging for PAD management.
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