How Do Various Imaging Techniques Compare for the Investigation of Peripheral Arterial Disease?
Imaging modalities for peripheral arterial disease are as follows: Conventional intraarterial angiography (cut film, digital, subtraction) remains the gold standard for assessing the vascular lumen. Digital techniques, nonionic contrast, and improvements in catheter and guidewire technology have resulted in safe, comfortable procedures with excellent image quality. Direct pressure measurements are easily made to assess hemodynamics, and real-time flow patterns can be observed. It must be remembered that even for diagnostic studies, the complication rate is not zero, and the resulting images are of the arterial lumen only. Information about the arterial wall such as the presence of aneurysms, mural thrombus, wall thickness, hematoma, or ulceration is best obtained using cross-sectional imaging techniques. Intravenous digital subtraction angiography involves a central venous bolus of contrast followed by delayed arterial x-ray imaging. One advantage is the lack of arterial puncture, but
