Hingorani Anil, Ascher Enrico, Marks Natalie, Mutyala Manykiam, Shiferson Alexander, Flyer Mark, Jacob Theresa
Division of Vascular Surgery, Department of Surgery, Mainmonides Medcine Center, Brooklyn, New York 11219, USA.
Vasc Endovascular Surg. 2007 Apr-May;41(2):115-9. doi: 10.1177/1538574406297265.
In an effort to explore alternatives to contrast arteriography, we compared computed tomography angiography to contrast arteriography for defining anatomic features of patients undergoing lower extremity revascularization. From November 2003 to March 2004, 36 inpatients with chronic lower extremity ischemia underwent contrast arteriography and computed tomography angiography before undergoing lower extremity revascularization procedures. A Siemens 16 slice multiplanar computed tomography device with bolus tracking was used for these exams. The reports of these tests and images were compared prospectively, and the differences in the aorto-iliac segment, femoral-popliteal, and infrapopliteal segments were noted. The vessels were classified as mild disease (<50%), moderate disease (50%-70%), severe (71%-99%), and occluded. The studies and treatment plans based on these data were compared. The mean age was 76 +/- 12 years (SD). Indications for the procedures included gangrene (45%), ischemic ulcer (32%), rest pain (19%), and severe claudication (3%); 69% were diabetics. Accuracy of computed tomography angiography in the aorto-iliac, femoral-popliteal, and infrapopliteal segments was 100%, 81%, and 59%, respectively. Thirteen of 18 (72%) of these disagreements resulted in a different procedure than that suggested by computed tomography angiography. A review of the data obtained in this series indicated that computed tomography angiography appears to be unable to obtain adequate information in this highly selected population at our institution.
为了探索血管造影的替代方法，我们将计算机断层血管造影（CTA）与血管造影进行了比较，以确定接受下肢血管重建术患者的解剖特征。2003年11月至2004年3月，36例慢性下肢缺血的住院患者在接受下肢血管重建术前接受了血管造影和计算机断层血管造影。这些检查使用了带有团注追踪功能的西门子16层多平面计算机断层扫描设备。对这些检查报告和图像进行了前瞻性比较，并记录了腹主动脉-髂动脉段、股-腘动脉段和腘动脉下段的差异。血管被分为轻度病变（<50%）、中度病变（50%-70%）、重度病变（71%-99%）和闭塞。比较了基于这些数据的研究和治疗方案。平均年龄为76±12岁（标准差）。手术指征包括坏疽（45%）、缺血性溃疡（32%）、静息痛（19%）和严重跛行（3%）；69%为糖尿病患者。CTA在腹主动脉-髂动脉段、股-腘动脉段和腘动脉下段的准确率分别为100%、81%和59%。这18例中有13例（72%）的分歧导致了与CTA建议的手术不同的手术。对本系列获得的数据进行回顾表明，在我们机构的这一高度选择的人群中，CTA似乎无法获得足够的信息。
