European Radiology

, Volume 5, Issue 2, pp 140–144 | Cite as

Digital distal lower limb angiography: comparison of selective iliac injection with vasodilators and bolus chasing technique

  • L. Podeur
  • Y. Rolland
  • A. Lucas
  • L. Ferté
  • M. Rambeau
  • R. Provensol
  • R. Duvauferrier
Original articles Cardiovascular radiology
  • 48 Downloads

Abstract

From October 1992 to May 1993 we carried out a prospective study on 30 patients, mean age 70 years, suffering from lower limb ischaemia (mild,n = 12; moderate,n = 9; severe,n = 9). Four masked investigators compared the outcome of two techniques for the preoperative evaluation of distal vessels of the lower limbs. The reference technique was digital subtraction angiography (DSA) with selective iliac injection, fixed centring on one ankle, and use so vasodilators. The new method was DSA with the so-called bolus chasing technique: after an injection above the aortic bifurcation, an acquisition during a continuous longitudinal translation movement allows all the arteries of the lower limbs to be visualised down to the most distal point. Both techniques are well tolerated and we found no significant difference in the number of distal arteries seen with the two methods. To assess the permeability of the distal lower limb network, the bolus tracking technique is as informative as an iliac selective injection, without its constraints. Consequently, we will routinely use it as the technique of choice.

Key words

Arteries Extremities Angiography 

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. 1.
    Kozak BE, Bedell JE, Rosch J (1988) Small vessel leg angiography for distal vessel bypass grafts. J Vasc Surg 8: 711–715PubMedGoogle Scholar
  2. 2.
    Courchia G, Serise JM, Moreau JL, et al (1988) L'angiographie peropératoire dans la chirurgie de restauration des membres inférieurs: à propos dúne expérience de 1099 cas. J Mal Vasc 13: 11–19PubMedGoogle Scholar
  3. 3.
    Petal KR, Semel L, Clauss RH (1988) Extended reconstruction rate for limb salvage with intraoperative prereconstruction angiography. J Vasc Surg 7: 531–537PubMedGoogle Scholar
  4. 4.
    Smith TP, Cragg AH, Berbaum KS, Nakagawa N (1993) Comparison of the efficacy of digital subtraction and film-screen angiography of the lower limb: prospective study in 50 patients. AJR 158: 431–436Google Scholar
  5. 5.
    Smith TP, Cragg AH, Berbaum KS, et al (1990) Techniques for lower limb angiography: a comparative study. Radiology 174: 951–955PubMedGoogle Scholar
  6. 6.
    Turnipseed WD, Detmer DE, Berkoff HA, et al (1982) Intra-arterial angiography: a new diagnostic method for determining limb salvage bypass candidates. Surgery 92: 322–327PubMedGoogle Scholar
  7. 7.
    Bartoli JM, Kuredjian S, Espinoza H, et al (1990) Apport de l'angiographie numérisée dans l'exploration des ischémies critiques des membres inférieurs. Ann Radiol 33: 250–254PubMedGoogle Scholar
  8. 8.
    Derdik H, Miller N, Adler J, et al (1986) Primary and adjunctive intra-arterial digital subtraction arteriography of the lower extremities. J Vasc Surg 5: 599–604Google Scholar
  9. 9.
    Friedman SG, Moccio CG (1989) A prospective comparison of intra-arterial digital subtraction and conventional angiography prior to lower extremity revascularization. Cardiovasc Surg 30: 462–466Google Scholar
  10. 10.
    Gomes A, Papin PJ, Mankovich NJ, Lois JF (1986) Digital subtraction angiography: a comparison of 5122 and 10242 imaging. AJR 146: 835–838PubMedGoogle Scholar
  11. 11.
    Millet A, Curet P (1989) Intérêt de l'angiographie numérisée dans le bilan pré-opératoire de l'artérite des membres inférieurs. J Radiol 70: 581–583PubMedGoogle Scholar
  12. 12.
    Darcy MD (1991) Lower extremity arteriography: current approach and techniques. Radiology 178: 615–621PubMedGoogle Scholar
  13. 13.
    Cohen MI, Vogelzang RL (1986) A comparison of techniques for improved visualization of the arteries of the distal lower extremity. AJR 147: 1021–1024PubMedGoogle Scholar
  14. 14.
    Duvauferrier R, Lucas C, Roche G, Ramée A (1992) Un nouveau concept en radiologie vasculaire: l'angiographie dynamique des vaisseaux périphériques. Rev Im Med 4: 149–152Google Scholar
  15. 15.
    Roche G (1992) L'angiographie dynamique des membres inférieurs: evaluation, optimisation et protocols. Thèse de Médecine, RennesGoogle Scholar
  16. 16.
    Duvauferrier R, Roche G, Aerts JC, Soly PF, Ramée A (1993) Dynamic angiography of the arteries of the lower limbs. MedicaMundi 38: 69–80Google Scholar
  17. 17.
    O'Mara CS, Flinn WR, Neiman HL, et al (1981) Correlation of foot arterial anatomy with early tibial bypass patency. Surgery 89: 743–751PubMedGoogle Scholar

Copyright information

© Springer-Verlag 1995

Authors and Affiliations

  • L. Podeur
    • 1
  • Y. Rolland
    • 1
  • A. Lucas
    • 2
  • L. Ferté
    • 2
  • M. Rambeau
    • 1
  • R. Provensol
    • 1
  • R. Duvauferrier
    • 1
  1. 1.Unité de Radiologie Vasculaire du Départment dÍmagerie et de Radilogie de l'Hôpital Sud de RennesRennesFrance
  2. 2.Service de Chirurgie Vasculaire de l'Hôpital Sud de RennesRennesFrance

Personalised recommendations