Can multi-detector computed tomographic angiography replace conventional angiography prior to lower extremity...

Computed tomographic (CT) angiography has become a valuable diagnostic technique prior to lower extremity arterial reconstruction. The purpose of this study is to evaluate its accuracy, compared to conventional angiography for planning lower limb revascularization procedures.

A prospective study was performed on all patients who underwent lower extremity arterial reconstruction procedures and had both CT angiography and conventional angiography between October 2003 and November 2005. We compared both modalities of angiography to intra-operative findings and whether a change in operative procedure would have resulted. The time for performance of both techniques and their complications were also reported.

Sixty nine patients were included in this study. Discrepancies between intra-operative findings and CT angiography were noted in four (6%) cases while there was none with conventional angiography (p = 0.127). Disagreements between intra-operative findings and CT angiography have lead to a different procedure in three (4.5%) cases and all were infra-inguinal. The time for performance of CT angiography was significantly shorter than that for conventional angiography (2.5 +/- 0.3 minutes vs 37.5 +/- 5.2, p = 0.006).

For arterial reconstructive procedures CT angiography provides a less invasive and accurate imaging with short examination time. It can be used as a primary imaging modality in evaluation of lower limb ischemia.