Ces radiol. 2008, 62(4):334-341

The impact of multidetector-row CT-angiography on treatment strategy in acute limb ischemiaOriginal article

Jiří Ferda¹, Milan Novák¹, František Šlauf¹, Petr Duras¹, Richard Šulc², Vilém Kuntscher², Vladislav Třeška²

¹ Radiodiagnostická klinika LF UK a FN, Plzeň

² Chirurgická klinika LF UK a FN, Plzeň

Aim: To assess a value of the multi-detector-row CT-angiography (MDCTA) of the lower extremity arteries in patients with acute limb ischemia from the point of view of proper therapy strategy.

Method: 106 examinations (72 males, 34 females, mean age 67.3 y., range 42-89 y.) performed due to the acute lower limb ischemia were analyzed retrospectively. Results of the MDCTA were assessed if they led directly to the endovascular or surgical or conservative therapy. All examinations were performed on 64-slice CT equipment (Sensation 64, Siemens Medical Solutions, Forchheim, Germany) using collimation 2× (32 × 0.6 mm), pitch factor of 1.5. 80-100 ml of iodinated contrast agent was administered into the antecubital vein with flow rate 4 ml/sec. The advent of the contrast agent into the examined territory was monitored with bolus tracking, the manual start was done when the first arise of the density in any artery was observed.

Results: Following causes of the ischemia were found: acute peripheral embolism (18 cases), occlusion of the peripheral artery (43 cases), occlusion of the abdominal aorta (7 cases), occlusion of the peripheral vascular graft (29 cases), other causes (9 cases). Diagnostic arteriography was performed only in 6 cases before starting the therapy.

Conclusion: Emergent MDCTA is sufficient imaging tool to stratify patient for endovascular or surgical treatment in acute limb ischemia.

Keywords: CT-angiography, acute limb ischemia

Grants and funding:

Práce byla podpořena výzkumným projektem MSM 0021620819.

Accepted: October 15, 2008; Published: December 1, 2008  Show citation