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S 64-ROW MULTI-DETECTOR COMPUTED TOMOGRAPHY ANGIOGRAPHY EQUAL TO DIGITAL SUBTRACTION ANGIOGRAPHY IN TREATMENT PLANNING IN CRITICAL LIMB ISCHEMIA?
Vesna Đurović Sarajlić
; Clinic for Radiology, Clinical Center University of Sarajevo, Sarajevo, Bosnia and Herzegovina
Dragan Totić
; Clinic for Cardiovascular Surgery, Clinical Center University of Sarajevo, Sarajevo, Bosnia and Herzegovina
Amina Bičo Osmanagić
; Clinic for Heart, Vascular Diseases and Rheumatology, Clinical Center University of Sarajevo, Sarajevo, Bosnia and Herzegovina
Refet Gojak
; Clinic for Infectious Diseases, Clinical Center University of Sarajevo, Sarajevo, Bosnia and Herzegovina
Lidija Lincender
; Policlinic Sunce Agram, Sarajevo, Bosnia and Herzegovina
Sažetak
Background: Critical limb ischemia (CLI) represents the end stage of peripheral arterial disease (PAD). It is defined as a
chronic ischemic rest pain, ulcers or gangrene, attributable to proven arterial occlusive disease. Intra-arterial digital subtr action
angiography (IA DSA) still represents the gold standard for the evaluation of steno-occlusive lesions, but it has greatly been
replaced with non-invasive multi-detector computed tomography angiography (MDCTA). The purpose of this prospective study was
to compare diagnostic performance of MDCTA versus DSA in treatment planning in patients with CLI according to TransAtlantic
Inter-Society Consensus Document on Management of Peripheral Arterial disease (TASC II).
Subjects and methods: The study was designed as prospective; it was conducted from March 2014 to August 2016, and included
60 patients with symptoms of CLI, Fontaine stage III and IV. MDCTA of the peripheral arteries was performed first, followed by
DSA. The lesions of aorto-iliac, femoro-popliteal and infra-popliteal regions were classified according to the TASC II guidelin es,
and inter-modality agreement between MDCTA and DSA was determined by using Kendall’s tau-b statistics.
Results: Inter-modality agreement was statistically significant in all three vascular beds, with excellent agreement >0.81 in
aortoiliac and femoropopliteal regions, and a very good agreement >0.61 in infrapopliteal region. Treatment recommendations
based on MDCTA findings and DSA findings were identical in 54 (90%) patients. In one patient (1.7%), CTA was not interpretable.
In five patients (8.3%), CTA findings disagreed with DSA findings in regard to the preferable treatment option.
Conclusion: 64-row MDCT angiography is highly competitive to DSA in evaluation of steno-occlusive disease and treatment
planning in patients with critical limb ischemia.
Ključne riječi
multi-detector computed tomography angiography; digital subtraction angiography; peripheral arterial disease; critical limb ischemi
Hrčak ID:
269464
URI
Datum izdavanja:
21.12.2019.
Posjeta: 256 *