Cone-Beam Computed Tomography Angiography Protocol Optimization in Peripheral and Visceral Interventions

Established cone-beam CT angiography protocols exist for neurointerventional, hepatic, and prostatic artery applications, but no widely accepted acquisition framework addresses renal embolization, gastrointestinal hemorrhage, pulmonary vascular intervention, or below-the-knee peripheral disease. This narrative review searched PubMed/MEDLINE, EMBASE, and the Cochrane Library through May 2025 for acquisition parameters and contrast protocols in these territories. Six interdependent variables (injection rate, contrast concentration, volume, scan delay, catheter position, and hemodynamics) govern image quality and must be optimized jointly. Territory-specific parameters are synthesized, and radiation considerations are addressed, with emphasis on total procedural exposure and on whether cone-beam acquisitions replace, rather than simply add to, other angiographic acquisitions.Level of Evidence Level 5. Narrative review of published literature without formal quality assessment or meta-analysis.