The benefits of internal thoracic artery catheterization in patients with chronic abdominal aortic occlusion

Area of Science:

• Vascular Surgery
• Diagnostic Imaging
• Interventional Radiology

Background:

• Abdominal aortic occlusion is often caused by thrombotic disease, leading to retrograde progression.
• Assessing distal arterial supply (run-off) is crucial for treatment planning in aortic occlusion.
• Traditional imaging methods may be limited, especially in areas with poor technical infrastructure.

Purpose of the Study:

• To evaluate the diagnostic benefit of selective internal thoracic angiography (ITA) for assessing distal run-off in patients with complete abdominal aortic occlusion.
• To compare the effectiveness of ITA with transaxillary aortography in visualizing lower extremity arterial supply.

Main Methods:

• A study involving 30 patients diagnosed with chronic abdominal aortic occlusion.
• Patients underwent both transaxillary aortography and selective internal thoracic angiography.
• Angiographic images were independently assessed by two radiologists using a predefined classification system to evaluate distal run-off visualization.

Main Results:

• Selective internal thoracic angiography demonstrated a significantly better angiographic score for distal run-off visualization.
• Good scores were achieved by 63.3% and 60% of patients by the two independent observers using ITA.
• Transaxillary aortography yielded substantially lower scores, with good results reported by only 20% and 3% of observers.

Conclusions:

• Selective internal thoracic angiography is a more effective method for visualizing lower extremity run-off in cases of chronic abdominal aortic occlusion.
• This technique provides superior diagnostic information compared to transaxillary aortography for assessing distal arterial patency.
• ITA is a valuable tool, particularly in settings with limited access to advanced imaging equipment.