Peripheral CT angiography in treatment planning and post-treatment monitoring of patients with peripheral arterial obstructive disease

Michele Anzidei

 

Introduction

Over the past two decades, CT angiography has become progressively available and increasingly reliable, both technically and clinically, resulting in substantial changes in the diagnostic approach to patients with peripheral arterial obstructive disease (PAOD) [1]. In particular, peripheral CT angiography has replaced conventional catheter angiography as the second-line diagnostic test before surgery or other interventions, with significant reductions in hospitalization costs and morbidity. Nowadays, patients with clinically suspected PAOD usually undergo Doppler ultrasound (DUS) as the first-line diagnostic test and, subsequently, CT angiography for treatment planning. Magnetic resonance angiography is also a valid second-level diagnostic option in patients with PAOD, but it requires more advanced scanner technology and an optimal acquisition technique to achieve the same clinical results as CT angiography [2]. For post-treatment evaluation, the first-line imaging modality remains DUS, while peripheral CT angiography is usually used to evaluate patients with more complex clinical findings or before re-intervention [3].

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