[Evaluation of arteritis of the lower limb. Conditions in which digitalized arteriography is sufficient]

Indications for arteriography in obliterative arterial disease of the lower limbs essentially involve assessments before dilatation or operation in the presence of disabling intermittent claudication or rest pain or gangrene or moderate symptoms when Doppler findings indicate the possibility of dilatation. In order to ensure the best selection of potential surgical patients and select the appropriate technique, arteriograms must show the entire arterial system from the coeliac aorta to the most distal point. Previously this could be obtained only by conventional arteriography using a large film cassette. In view of the advantages of digitalized arteriography via an arterial approach, the possibility of obtaining equally accurate and continuous images with this technique were evaluated. The method involved 12 to 15 successive injections, with a mean total dose of 100 ml of contrast medium, precise identification of X-ray fields and end to end mounting of films. Not only were the images of identical quality, but this quality appeared to be more constant and it was often possible to visualize distal arteries with a low flow rate. Complications were exceptional in view of the absence of general anesthesia, use of a finer catheter and fractionnation of injections of contrast medium. The majority of these investigations were carried out on an ambulatory basis, whilst the majority of standard arteriograms require hospitalization. Patient comfort was increased and cost decreased. In conclusion, digitalized arteriography by an arterial approach offers a complete image of the arterial system from the renal arteries to the pedal arches provided X-ray fields are carefully identified and films are mounted end to end.(ABSTRACT TRUNCATED AT 250 WORDS)