Intravenous digital subtraction angiography. Collateral circulation to 'empty leg'.

Area of Science:

• Vascular Surgery
• Diagnostic Imaging
• Radiology

Background:

• Iliac artery occlusion can compromise lower limb perfusion.
• Collateral circulation pathways are crucial for maintaining blood flow.
• Thoracic artery contributions to iliac collateralization are not always well-defined.

Purpose of the Study:

• To investigate the presence and characteristics of collateral blood supply originating from thoracic arteries in patients with common or external iliac artery occlusion.
• To evaluate the utility of intravenous digital subtraction angiography (DSA) for visualizing these thoracic collateral pathways.

Main Methods:

• Intravenous digital subtraction angiography (DSA) was performed on 60 patients with uni- or bilateral common or external iliac artery occlusion.
• A Sirecon 33 triplex N image intensifier with a 30 cm effective field size was utilized.
• Simultaneous visualization of thoracic arterial pathways and non-occluded leg arteries was achieved.

Main Results:

• Out of 60 patients, 12 (20%) demonstrated collateral blood supply originating from the internal mammary or lateral thoracic arteries.
• Intravenous DSA successfully and easily demonstrated the thoracic arterial pathways.
• Simultaneous imaging of leg arteries was also effectively achieved.

Conclusions:

• Thoracic arteries can serve as a significant collateral source in patients with iliac artery occlusion.
• Intravenous DSA is a valuable and effective imaging modality for delineating these thoracic collateral pathways and assessing lower limb perfusion.