DIAGNOSIS OF PERIPHERAL VASCULAR DISEASES AND THE PATENCY OF FEMORO-DISTAL BYPASS BY COMPUTED TOMOGRAPHIC ANGIOGRAPHY

Successful management of patients with peipheral vascular disease reqiures detailed vascular imaging, usually 
performed by contrast angiography. Arteriography, however, is not without limitations and risks, including failure to 
identify patent runoff vessels suitable for use in limb salvage procedures in up to 70% of patients. We used computed 
tomographic angiography (CTA) in preoperative imaging of the peripheral vascular tree of 15 pateints. Conventional 
angiography and magnetic resonance angiography were used in some patients in addition to CTA to compare their ability in the detection of peripheral vessel and femoro-distal bypass graft patency and the presence of hemodynamically significant stenoses. The findings of CTA were verified by direct operative exploration. CTA accurately detected patent and occluded arterial segments and hemodynamically signifacant stenoses as well as arteriograpy and MRA. Therapeutic plans based on either CTA or conventional arteriography were identical. Conclusions: 1- CTA is a noninvasive imaging technique, obviating arterial puncture and contrast. 2- the sensitivity of CTA for slow flow makes it a very good screening device for vessel and bypass graft patency. 3- Review of the individual axial images not only indicates the exact level at which vessels are patent but also provides a three-dimensional view of stenotic lesions.