The role of infrapopliteal MR angiography in patients undergoing optimal contrast angiography for chronic limb-threatening ischemia

John R. Leyendecker, Kelcey D. Elsass, Stephen P. Johnson, Daniel C. Diffin, David L. Cull, Jerry T. Light, David L Dawson

Research output: Contribution to journalArticle

11 Citations (Scopus)

Abstract

PURPOSE: To determine the benefit of infrapopliteal magnetic resonance angiography (MRA) in patients with chronic limb-threatening ischemia who have undergone optimal contrast angiography (CA). PATIENTS AND METHODS: Thirty- four patients (37 limbs) with limb-threatening chronic lower extremity ischemia underwent MRA and CA of the symptomatic extremity. Selective, vasodilator-enhanced digital subtraction angiography of the infrapopliteal vessels was possible for 34 limbs. Two vascular surgeons retrospectively formulated treatment plans based on CA. They then formulated treatment plans based on CA and MRA together. RESULTS: CA clearly visualized 495 of 888 vascular segments as patent, while MRA clearly visualized 412 of 888 segments. Treatment plans differed for at least one of two surgeons in eight limbs, but MRA would possibly have improved clinical outcome in only one. The amount of inflow disease did not appear to influence segment visualization or treatment planning. In eight of 11 limbs that eventually required below- or above-knee amputation, CA clearly visualized more vascular segments than MRA. One patient developed renal insufficiency after CA. CONCLUSION: Most patients undergoing optimal CA for chronic limb-threatening ischemia will not benefit from the addition of MRA. However, MRA should be considered when CA is suboptimal and when it is necessary to conserve contrast material.

Original languageEnglish (US)
Pages (from-to)545-551
Number of pages7
JournalJournal of Vascular and Interventional Radiology
Volume9
Issue number4
StatePublished - 1998
Externally publishedYes

Fingerprint

Magnetic Resonance Angiography
Angiography
Ischemia
Extremities
Blood Vessels
Knee
Digital Subtraction Angiography
Therapeutics
Vasodilator Agents
Amputation
Contrast Media
Renal Insufficiency
Lower Extremity

Keywords

  • Angiography, comparative studies
  • Arteries, extremities
  • Arteries, stenosis or obstruction
  • Magnetic resonance (MR), vascular studies

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Radiological and Ultrasound Technology

Cite this

The role of infrapopliteal MR angiography in patients undergoing optimal contrast angiography for chronic limb-threatening ischemia. / Leyendecker, John R.; Elsass, Kelcey D.; Johnson, Stephen P.; Diffin, Daniel C.; Cull, David L.; Light, Jerry T.; Dawson, David L.

In: Journal of Vascular and Interventional Radiology, Vol. 9, No. 4, 1998, p. 545-551.

Research output: Contribution to journalArticle

Leyendecker, John R. ; Elsass, Kelcey D. ; Johnson, Stephen P. ; Diffin, Daniel C. ; Cull, David L. ; Light, Jerry T. ; Dawson, David L. / The role of infrapopliteal MR angiography in patients undergoing optimal contrast angiography for chronic limb-threatening ischemia. In: Journal of Vascular and Interventional Radiology. 1998 ; Vol. 9, No. 4. pp. 545-551.
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N2 - PURPOSE: To determine the benefit of infrapopliteal magnetic resonance angiography (MRA) in patients with chronic limb-threatening ischemia who have undergone optimal contrast angiography (CA). PATIENTS AND METHODS: Thirty- four patients (37 limbs) with limb-threatening chronic lower extremity ischemia underwent MRA and CA of the symptomatic extremity. Selective, vasodilator-enhanced digital subtraction angiography of the infrapopliteal vessels was possible for 34 limbs. Two vascular surgeons retrospectively formulated treatment plans based on CA. They then formulated treatment plans based on CA and MRA together. RESULTS: CA clearly visualized 495 of 888 vascular segments as patent, while MRA clearly visualized 412 of 888 segments. Treatment plans differed for at least one of two surgeons in eight limbs, but MRA would possibly have improved clinical outcome in only one. The amount of inflow disease did not appear to influence segment visualization or treatment planning. In eight of 11 limbs that eventually required below- or above-knee amputation, CA clearly visualized more vascular segments than MRA. One patient developed renal insufficiency after CA. CONCLUSION: Most patients undergoing optimal CA for chronic limb-threatening ischemia will not benefit from the addition of MRA. However, MRA should be considered when CA is suboptimal and when it is necessary to conserve contrast material.

AB - PURPOSE: To determine the benefit of infrapopliteal magnetic resonance angiography (MRA) in patients with chronic limb-threatening ischemia who have undergone optimal contrast angiography (CA). PATIENTS AND METHODS: Thirty- four patients (37 limbs) with limb-threatening chronic lower extremity ischemia underwent MRA and CA of the symptomatic extremity. Selective, vasodilator-enhanced digital subtraction angiography of the infrapopliteal vessels was possible for 34 limbs. Two vascular surgeons retrospectively formulated treatment plans based on CA. They then formulated treatment plans based on CA and MRA together. RESULTS: CA clearly visualized 495 of 888 vascular segments as patent, while MRA clearly visualized 412 of 888 segments. Treatment plans differed for at least one of two surgeons in eight limbs, but MRA would possibly have improved clinical outcome in only one. The amount of inflow disease did not appear to influence segment visualization or treatment planning. In eight of 11 limbs that eventually required below- or above-knee amputation, CA clearly visualized more vascular segments than MRA. One patient developed renal insufficiency after CA. CONCLUSION: Most patients undergoing optimal CA for chronic limb-threatening ischemia will not benefit from the addition of MRA. However, MRA should be considered when CA is suboptimal and when it is necessary to conserve contrast material.

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