Multi Detector Row Computed Tomography Angiogram as the Sole Preoperative Imaging for Infrainguinal Arterial Surgery

Kwon, Soo Bum; Park, Ki Hyuk; Jung, Soon Jae; Choi, Dong Rak; Joo, Dae Hyun; Lee, Han Il; Park, Sung Hwon; Yu, Yong Woon; Park, Ki Ho

Abstract

PURPOSE
To assess the suitability of multidetector row CT angiogram (MDCTA) as the sole preoperative imaging for infrainguinal arterial surgery. METHOD: From March 2002 to September 2003, 75 patients (24 claudicants, 41 limb-threatening ischemia) were studied with MDCTA preoperatively. We compared the surgical inflow and outflow site changes between preoperative planning based on MDCTA and the results of final operation. MDCTA was interpreted by the same vascular surgeon, and arterial segments from the renal artery to foot were reviewed. Surgery plans were formulated based on arterial anatomic and hemodynamic characteristics. Additional diagnostic value and test related complications were also studied. RESULT: Twenty- one patients had conventional angiogram after MDCTA scan - 9 for interventional treatment at inflow site and 12 patients for complement of MDCTA, although the operation plan was not changed. The agreement between preoperative plan based on MDCTA and final operation was 100% even in critical limb ischemia. In 11 patients tortuous calcified iliac artery was ambiguous in routine image but it could be solved using the other specific functional option of MDCTA. There were no serious complications related to the test.
CONCLUSION
These findings suggest that MDCTA is an adequate preoperative imaging study of infrainguinal arterial surgery and that it may be substituted for conventional angiogram without any serious complication. The particular functional options of MDCTA help resolve its defect.