Peripheral artery disease

Because of their relatively large size, lack of motion, and straight course, assessment of peripheral arteries, including the identification and quantification of luminal stenosis, can be performed with computed tomography (CT) angiography (Figure 11.1). ^387,388 Vessel wall calcification remains a major limitation, in particular in smaller vessels. Multi-detector computed tomography (MDCT) protocols typically use a spiral examination mode with thin, overlapping images and rapid contrast bolus injection. ³⁸⁹ CT angiography has developed into an alternative imaging modality in several vascular regions. The experience in lower-extremity peripheral artery disease (PAD) imaging is described below. The assessment of subclavian artery access in the context of transcatheter aortic valve replacement (TAVR) is discussed in Chapter 7. In neuroradiology, modern systems allow simultaneous imaging of the carotid arteries, intracranial vessel, brain morphology, and brain perfusion. ³⁹⁰ CT angiography is increasingly being used as a “road map” for subsequent angioplasty. ^391–400 Disadvantages of CT in comparison with ultrasound and MRI are the associated radiation exposure and the lack of flow information. Figure 11.1 Iliac arteries https://s3-euw1-ap-pe-df-pch-content-public-p.s3.eu-west-1.amazonaws.com/9780429186318/82d84425-00cf-4291-bf75-b4e9afc9ca9b/content/fig11_1.jpg"/> This figure shows centerline reconstructions of the left and right iliac arteries.