Role of Multi Slice - CT Angiography in Evaluation of Lower Limb Ischemic Disease

Abstract
Background: Peripheral Arterial Disease (PAD) is one of the major manifestations of systemic atherosclerosis affecting 12% of the adult population and up to 20% of elderly persons. The most severe form of PAD, Critical or Limb-threatening Ischemia (CLI) occurs when arterial blood flow is restricted so severely that perfusion of capillary beds is inadequate to sustain tissue viability. Many patients do not progress sequen-tially along predefined stages from claudication to CLI. As described in selected longitudinal studies, some patients with symptomatic PAD have been shown to develop CLI, while data from other studies have shown that many patients are asymptomatic prior to the development of CLI.
Aim of Study: Evaluate the role of multidetectior CT angiography in evaluation and diagnosis of lower limb ischemia.
Patients and Methods: This study includes thirty patients who were referred to the Radiology Department of Tanta University Hospital from the Vascular Surgery Department with suspected aorto-iliac arterial disease. They underwent multi-detector row CT angiography of the aorto-iliac arteries.
Results: From the 30 cases in our study, the major symptom present in 30 cases is intermittent claudication but in different stages according to fontain classification, stage I in zero patient, stage II in 15 patient divided into 6 in IIa and 9 in IIb, stage III in 10 patients and stage IV in 5 patients.
Conclusion: We predict that MDCT angiography can replace DSA and CCD in the examination of the aortoiliac arteries especially with the development of the new generations of multislice CT e.g. 128 or 160 channel MSCT and become the investigation of choice in this territory.