Femoropopliteal disease

Lower-extremity CTA can be performed with all currently available MDCT scanners. No special hardware is required. Because of the slightly thicker sections (2.5-3 mm) usually obtained with four-channel MDCT (4 X 2.5 mm), evaluation of crural and pedal arteries is slightly limited, notably if calcifications are present. The technical limitations of four-channel MDCT are only clinically problematic in a small subset of patients, such as individuals with critical limb ischemia who have no or mild inflow and femoropopliteal disease, and who have diseased and calcified infrapopliteal vessels. In the majority of patients—notably those with intermittent claudication where interventions are limited to aboveknee arteries—even four-channel MDCT can provide all the therapeutically relevant information (Heijen-brok-Kal et al. 2007 Rubin et al. 2001 Ofer et al. 2003 Martin et al. 2003 Ota et al. 2004 Catalano et al. 2004). 

Unlabeled Uses Acute peripheral occlusive disease, basilar artery occlusion, cerebral infarction, deep vein thrombosis, femoropopliteal artery occlusion, mesenteric or subclavian vein occlusion, pleural effusion (parapneumonic)... 

There are three levels of occlusive disease in the lower limb arteries aortoiliac, femoropopliteal, and infrapopliteal disease. Disease confined to one level may be asymptomatic or it can present with intermittent claudication. The presence of two or three levels of disease are symptomatic, and patients usually present with severe claudication or rest pain. Three levels of disease are often seen in patients with skin damage and critical limb ischemia. Without an intervention most limbs with critical ischemia will be amputated within 1 year. In patients with diabetes mellitus the disease is usually confined in the infrapopliteal vessels. Such patients may develop critical limb ischemia with one level of disease because this is the most distal of the three. Usually, multiple stenoses and/or occlusions are found in at least two of the run-off arteries. Although it is known that atherosclerosis develops most often in bifurcations, in the lower extremities the most frequently involved site is the superficial femoral artery. Other common sites are the aortoiliac, iliac, femoral popliteal, and tibioperoneal trunk bifurcations. 

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