[Peripheral venous and peripheral arterial digital subtraction angiography in occlusive diseases of the lower...

The possibility of employing peripheral venous and peripheral arterial digital subtraction angiography was examined in 351 patients of 65 to 95 years of age with arterial occlusive disease of the lower extremity. After peripheral venous contrast medium injection (using a Venflon needle 1.7-2.0 mm, 40 ml nonionic contrast medium, 20-30 ml NaCl, flow 15/s), conclusive assessment of vascular tone is possible in 86% of the cases. Indication for IV DSA is supplied chiefly by stenoses and occlusions situated proximally or bilaterally in the region of the distal aorta abdominalis, the iliacal, femoral and popliteal arteries. The distal adjacent segment is demonstrated well in 81 to 95 per cent of the cases up to the level of the trifurcation. Image quality is poor in 30% of the images of the lower leg, whereas no assessment is possible in 11% of the cases. IA DSA with fine needle (needle 0.8 mm, 3-5 ml contrast medium, 3-7 ml NaCl) is indicated in 8% of the patients to clarify the distal lower leg arteries, especially in preceding extensive proximal vascular occlusions. Conventional angiography can be largely replaced by combining peripheral venous and peripheral arterial DSA with fine needle technique.