Lower Extremity CT Angiography in Peripheral Arterial Disease: from the Established Approach to Evolving Technical Developments

Overview

Journal Int J Cardiovasc Imaging

Publisher Springer

Specialty Radiology

Date 2021 May 17

PMID 33997924

Citations 12

Authors

Omar Shwaiki

Basem Rashwan

Matthias A Fink

Levester Kirksey

Sameer Gadani

Karunakaravel Karuppasamy

Claudius Melzig

Dustin Thompson

Giuseppe DAmico

Fabian Rengier

Sasan Partovi

Affiliations

Soon will be listed here.

Abstract

With the advent of multidetector computed tomography (CT), CT angiography (CTA) has gained widespread popularity for noninvasive imaging of the arterial vasculature. Peripheral extremity CTA can nowadays be performed rapidly with high spatial resolution and a decreased amount of both intravenous contrast and radiation exposure. In patients with peripheral artery disease (PAD), this technique can be used to delineate the bilateral lower extremity arterial tree and to determine the amount of atherosclerotic disease while differentiating between acute and chronic changes. This article provides an overview of several imaging techniques for PAD, specifically discusses the use of peripheral extremity CTA in patients with PAD, clinical indications, established technical considerations and novel technical developments, and the effect of postprocessing imaging techniques and structured reporting.

Citing Articles

In vitro and in vivo optimized reconstruction for low-keV virtual monoenergetic photon-counting detector CT angiography of lower legs.

Graafen D, Bart W, Halfmann M, Muller L, Hobohm L, Yang Y Eur Radiol Exp. 2024; 8(1):89.

PMID: 39090380 PMC: 11294310. DOI: 10.1186/s41747-024-00481-x.

Sarcopenia in peripheral arterial disease: Establishing and validating a predictive nomogram based on clinical and computed tomography angiography indicators.

Nie L, Yang Q, Song Q, Zhou Y, Zheng W, Xu Q Heliyon. 2024; 10(7):e28732.

PMID: 38590906 PMC: 10999995. DOI: 10.1016/j.heliyon.2024.e28732.

The Clinical Utility of Lower Extremity Dual-Energy CT Angiography in the Detection of Bone Marrow Edema in Diabetic Patients with Peripheral Artery Disease.

Floridi C, Cacioppa L, Valeri T, Rossini N, Rosati M, Vento V J Clin Med. 2024; 13(6).

PMID: 38541762 PMC: 10970906. DOI: 10.3390/jcm13061536.

Association of lower extremity peripheral arterial disease with quantitative muscle features from computed tomography angiography.

Hu G, Chen Y, Mu C, Zhang X, Wang Y, Wang Y Insights Imaging. 2024; 15(1):95.

PMID: 38536535 PMC: 10973322. DOI: 10.1186/s13244-024-01663-2.

Low-iodine 40-keV virtual monoenergetic CT angiography of the lower extremities.

Fahrni G, Mingas T, Deliessche A, Hraichi S, Rotzinger D, Si-Mohamed S Front Cardiovasc Med. 2023; 10:1276738.

PMID: 37942065 PMC: 10629994. DOI: 10.3389/fcvm.2023.1276738.

References

Criqui M, Aboyans V . Epidemiology of peripheral artery disease. Circ Res. 2015; 116(9):1509-26. DOI: 10.1161/CIRCRESAHA.116.303849. View

Fowkes F, Rudan D, Rudan I, Aboyans V, Denenberg J, McDermott M . Comparison of global estimates of prevalence and risk factors for peripheral artery disease in 2000 and 2010: a systematic review and analysis. Lancet. 2013; 382(9901):1329-40. DOI: 10.1016/S0140-6736(13)61249-0. View

Ergun E, Kosar P, Ozturk C, Basbay E, Koc F, Kosar U . Prevalence and extent of coronary artery disease determined by 64-slice CTA in patients with zero coronary calcium score. Int J Cardiovasc Imaging. 2010; 27(3):451-8. DOI: 10.1007/s10554-010-9681-5. View

Pande R, Perlstein T, Beckman J, Creager M . Secondary prevention and mortality in peripheral artery disease: National Health and Nutrition Examination Study, 1999 to 2004. Circulation. 2011; 124(1):17-23. PMC: 3139992. DOI: 10.1161/CIRCULATIONAHA.110.003954. View

Selvin E, Erlinger T . Prevalence of and risk factors for peripheral arterial disease in the United States: results from the National Health and Nutrition Examination Survey, 1999-2000. Circulation. 2004; 110(6):738-43. DOI: 10.1161/01.CIR.0000137913.26087.F0. View

Takx R, Partovi S, Ghoshhajra B . Imaging of atherosclerosis. Int J Cardiovasc Imaging. 2015; 32(1):5-12. DOI: 10.1007/s10554-015-0730-y. View

Conte M, Pomposelli F, Clair D, Geraghty P, McKinsey J, Mills J . Society for Vascular Surgery practice guidelines for atherosclerotic occlusive disease of the lower extremities: management of asymptomatic disease and claudication. J Vasc Surg. 2015; 61(3 Suppl):2S-41S. DOI: 10.1016/j.jvs.2014.12.009. View

Fernandez-Friera L, Penalvo J, Fernandez-Ortiz A, Ibanez B, Lopez-Melgar B, Laclaustra M . Prevalence, Vascular Distribution, and Multiterritorial Extent of Subclinical Atherosclerosis in a Middle-Aged Cohort: The PESA (Progression of Early Subclinical Atherosclerosis) Study. Circulation. 2015; 131(24):2104-13. DOI: 10.1161/CIRCULATIONAHA.114.014310. View

Laclaustra M, Casasnovas J, Fernandez-Ortiz A, Fuster V, Leon-Latre M, Jimenez-Borreguero L . Femoral and Carotid Subclinical Atherosclerosis Association With Risk Factors and Coronary Calcium: The AWHS Study. J Am Coll Cardiol. 2016; 67(11):1263-74. DOI: 10.1016/j.jacc.2015.12.056. View

10.

Diehm N, Shang A, Silvestro A, Do D, Dick F, Schmidli J . Association of cardiovascular risk factors with pattern of lower limb atherosclerosis in 2659 patients undergoing angioplasty. Eur J Vasc Endovasc Surg. 2005; 31(1):59-63. DOI: 10.1016/j.ejvs.2005.09.006. View

11.

Haltmayer M, Mueller T, Horvath W, Luft C, Poelz W, Haidinger D . Impact of atherosclerotic risk factors on the anatomical distribution of peripheral arterial disease. Int Angiol. 2001; 20(3):200-7. View

12.

Lin J, Olson C, Johnson E, Whitlock E . The ankle-brachial index for peripheral artery disease screening and cardiovascular disease prediction among asymptomatic adults: a systematic evidence review for the U.S. Preventive Services Task Force. Ann Intern Med. 2013; 159(5):333-41. DOI: 10.7326/0003-4819-159-5-201309030-00007. View

13.

Lijmer J, Hunink M, van den Dungen J, Loonstra J, Smit A . ROC analysis of noninvasive tests for peripheral arterial disease. Ultrasound Med Biol. 1996; 22(4):391-8. DOI: 10.1016/0301-5629(96)00036-1. View

14.

Khan T, Farooqui F, Niazi K . Critical review of the ankle brachial index. Curr Cardiol Rev. 2009; 4(2):101-6. PMC: 2779349. DOI: 10.2174/157340308784245810. View

15.

Hoyer C, Sandermann J, Petersen L . The toe-brachial index in the diagnosis of peripheral arterial disease. J Vasc Surg. 2013; 58(1):231-8. DOI: 10.1016/j.jvs.2013.03.044. View

16.

Hashimoto T, Ichihashi S, Iwakoshi S, Kichikawa K . Combination of pulse volume recording (PVR) parameters and ankle-brachial index (ABI) improves diagnostic accuracy for peripheral arterial disease compared with ABI alone. Hypertens Res. 2016; 39(6):430-4. DOI: 10.1038/hr.2016.13. View

17.

Patel M, Levin D, Parker L, Rao V . Have CT and MR Angiography Replaced Catheter Angiography in Diagnosing Peripheral Arterial Disease?. J Am Coll Radiol. 2015; 12(9):909-14. DOI: 10.1016/j.jacr.2015.04.020. View

18.

Gerhard-Herman M, Gornik H, Barrett C, Barshes N, Corriere M, Drachman D . 2016 AHA/ACC Guideline on the Management of Patients With Lower Extremity Peripheral Artery Disease: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. Circulation. 2016; 135(12):e726-e779. PMC: 5477786. DOI: 10.1161/CIR.0000000000000471. View

19.

Sun Z . Diagnostic accuracy of multislice CT angiography in peripheral arterial disease. J Vasc Interv Radiol. 2006; 17(12):1915-21. DOI: 10.1097/01.RVI.0000248830.17550.50. View

20.

Fraioli F, Catalano C, Napoli A, Francone M, Venditti F, Danti M . Low-dose multidetector-row CT angiography of the infra-renal aorta and lower extremity vessels: image quality and diagnostic accuracy in comparison with standard DSA. Eur Radiol. 2005; 16(1):137-46. DOI: 10.1007/s00330-005-2812-z. View