Hingorani A, Ascher E, Markevich N, Kallakuri S, Schutzer R, Yorkovich W, Jacob T, et al.
Annals of vascular surgery. Date of publication 2004 May 1;volume 18(3):294-301.
1. Ann Vasc Surg. 2004 May;18(3):294-301.
A comparison of magnetic resonance angiography, contrast arteriography, and
duplex arteriography for patients undergoing lower extremity revascularization.
Hingorani A(1), Ascher E, Markevich N, Kallakuri S, Schutzer R, Yorkovich W,
Jacob T.
Author information:
(1)Department of Surgery, Division of Vascular Surgery, Maimonides Medical
Center, Brooklyn, NY 11219, USA.
The objective of this study was to compare magnetic resonance angiography (MRA),
contrast arteriography (CA), and duplex arteriography (DA) for defining anatomic
features relevant to performing lower extremity revascularizations. From March 1,
2001 to August 1, 2001, 33 consecutive inpatients with chronic lower extremity
ischemia underwent CA, MRA, and DA before undergoing lower extremity
revascularization procedures. The reports of these tests were compared
prospectively and the differences in the aortoiliac segment, femoral-popliteal,
and infrapopliteal segments were noted. The vessels were classified as mild
disease (<50%), moderate disease (50-70%), severe disease (71-99%), and occluded.
These studies and treatment plans based on these data were compared. During this
time period, 11 patients were not able to undergo MRA and therefore were excluded
from the study. Thirty-three patients were included in this study. These patients
underwent 35 procedures, as 2 patients underwent bilateral procedures. The mean
age of the 33 patients was 76+/-10 years (SD). Indications for the procedures
included gangrene (20), ischemic ulcer (8), rest pain (4), and severe
claudication (1). Patients' medical history included diabetes mellitus (25),
hypertension (20), and end-stage renal disease (5). No differences were noted
between intraoperative findings and CA in this series. Two of the three
differences between DA and CA were felt to be clinically significant whereas 9 of
the 12 differences between MRA and CA were felt to be clinically significant. On
the basis of these data in this series, MRA does not yet seem to be able to
obtain adequate data on infrapopliteal segments, at least not for this highly
selected population. When severe tibial calcification or very low flow states are
identified, CA may be necessary for patients undergoing DA.
DOI: 10.1007/s10016-004-0039-0
PMID: 15354630 [Indexed for MEDLINE]
