From the Guidelines
The result of a right lower extremity arterial scan is typically used to diagnose and evaluate the presence and severity of peripheral artery disease (PAD) in the lower extremities.
Key Findings
- The scan can detect stenoses, occlusions, and aneurysms in the arteries of the lower extremities 1.
- CTA and MRA are commonly used imaging modalities for evaluating lower extremity arterial disease, with CTA offering advantages in terms of rapid acquisition and better safety in patients with pacemakers or defibrillators 1.
- The scan can also identify collaterals and arteries distal to occlusions, which may not be visible on catheter angiography images 1.
Imaging Modalities
- CTA is a cross-sectional technique that provides volumetric images, enabling extensive image postprocessing and creation of an arterial road map 1.
- MRA is also a cross-sectional technique, but may be limited by contraindications such as pacemakers or defibrillators, and may produce more severe artifacts from metal 1.
- Catheter angiography is a projectional technique that provides detailed information about arterial anatomy, but may be limited by its invasive nature and potential risks 1.
Clinical Applications
- The results of a right lower extremity arterial scan can be used to plan treatment, including revascularization and assessment of stenoses 1.
- The scan can also be used to evaluate the length, severity, and number of stenoses, as well as to identify bypass grafts and aneurysms 1.
Limitations
- Heavily calcified atheromatous disease can limit the ability to interpret CTA images, particularly in tibial arteries 1.
- Dual-energy CTA can reduce blooming and beam-hardening artifact created by heavily calcified atheromatous disease and metallic stents 1.
From the Research
Results of a Right Lower Extremity Arterial Scan
The results of a right lower extremity arterial scan can vary depending on the imaging modality used and the clinical question of interest. Some possible results include:
- Diagnosis of peripheral artery disease (PAD) or trauma affecting the lower extremities 2, 3, 4
- Identification of nonischemic etiologies such as vasculitis, aneurysms, and congenital vascular malformations 2, 5
- Evaluation of the severity of arterial occlusive disease, location of lesions, and determination of appropriate interventional techniques 3, 6
- Assessment of limb perfusion and detection of hypoperfused areas 4
- Planning of revascularization strategy in patients with severe PAD and evaluation of therapeutic outcome 4, 6
- Determination of prognosis and amputation risk in patients with PAD 4
Imaging Modalities
Different imaging modalities can be used to perform a right lower extremity arterial scan, including:
- Computed Tomography Angiography (CTA) 2, 6, 5
- Duplex sonography 3
- Digital subtraction angiography (DSA) 3, 6
- Magnetic Resonance Imaging (MRI) 4
- Scintigraphy 4
Diagnostic Accuracy
The diagnostic accuracy of a right lower extremity arterial scan can vary depending on the imaging modality used and the clinical question of interest. For example: