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64-section CT angiography in patients with critical limb ischaemia and severe claudication: comparison with digital

N Fotiadis1, C Kyriakides, C Bent

  • 1Department of Diagnostic Imaging, Barts and The London NHS Trust, London, UK. nicos.fotiadis@bartsandthelondon.nhs.uk

Clinical Radiology
|June 11, 2011
PubMed

Insights

64-section multidetector computed tomography (MDCT) angiography accurately assesses lower-limb arterial disease in patients with critical limb ischaemia (CLI) or intermittent claudication (IC), aiding treatment planning.

Area of Science:

  • Vascular Imaging
  • Radiology
  • Interventional Cardiology

Background:

  • Critical limb ischaemia (CLI) and severe intermittent claudication (IC) significantly impact patient mobility and quality of life.
  • Accurate pre-treatment assessment of lower-limb arterial disease is crucial for effective endovascular intervention planning.

Purpose of the Study:

  • To evaluate the diagnostic utility of 64-section multidetector computed tomography (MDCT) angiography.
  • To assess its capability in grading lower-limb arterial disease severity for patients with CLI or severe IC prior to endovascular treatment.

Main Methods:

  • Forty-one patients with CLI or severe IC underwent 64-section MDCT angiography.
  • MDCT results were compared against intra-arterial digital subtraction angiography (IADSA) performed during endovascular intervention.
  • Independent readers, blinded to the other imaging modality, scrutinized both MDCT and IADSA examinations.

Main Results:

  • MDCT demonstrated high diagnostic performance for haemodynamically significant arterial disease (stenosis ≥50%).
  • Overall sensitivity was 99%, specificity 98%, and accuracy 98%.
  • Positive predictive value (PPV) was 97% and negative predictive value (NPV) was 99% for MDCT.

Conclusions:

  • 64-section MDCT angiography is a valuable tool for evaluating patients with severe claudication and CLI.
  • It reliably grades disease severity, supporting informed treatment planning for endovascular procedures.
Abstract

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