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Effect of MDCT Angiographic Findings on the Management of Intermittent Claudication

¹ Department of Cardiovascular and Interventional Radiology, Medical University of Vienna, Währinger Gürtel, 18-20, Vienna 1090, Austria.
² Present address: Department of Radiology, Stanford University Medical Center, Stanford, CA.

OBJECTIVE. The purpose of this study was to assess the reliability of treatment decisions based on MDCT angiographic findings of stage IIb peripheral arterial occlusive disease (PAOD).

MATERIALS AND METHODS. Fifty-eight patients with stage IIb PAOD underwent CT angiography of the abdominal aorta and runoff vessels for further treatment planning. Treatment reports, discharge summaries, and follow-up examinations were reviewed to determine the number of treatments correctly planned on the basis of CT angiographic findings.

RESULTS. On the basis of CT angiographic findings, endovascular treatment was indicated for 18 patients, surgical revascularization for nine patients, and a combined endovascular and surgical approach for two patients. Conservative treatment was indicated for 29 patients. On the basis of successful revascularization, the correctness of the treatment decision was confirmed in all but one patient (n = 28). The treatment plan was modified for one patient referred for surgical revascularization. In that patient, stenosis of the common femoral artery had been overlooked on CT angiography. Patients for whom conservative management was indicated on the basis of CT angiographic findings (n = 29) had a mean follow-up period of 501 days without needing revascularization treatment. This result was defined as indirect confirmation of the accuracy of the decision made with CT angiography.

CONCLUSION. The findings on MDCT angiography led to correct treatment recommendations for patients with claudication. Thus, CT angiography should be used in the management of PAOD.

Keywords: claudication • CT angiography • peripheral arterial occlusive disease • treatment decision • vascular imaging

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