THE POTENTIAL FOR LOWER-EXTREMITY REVASCULARIZATION WITHOUT CONTRAST ARTERIOGRAPHY - EXPERIENCE WITH MAGNETIC-RESONANCE ANGIOGRAPHY

Purpose: We report an initial experience with 24 patients studied betw een March 1990 and April 1992 with magnetic resonance angiography (MRA ) for lower extremity occlusive disease. Methods: All patients underwe nt vascular intervention with either balloon angioplasty or bypass gra fting, and in six patients this intervention was based on MRA findings alone. Eighteen patients were studied with both MRA and contrast arte riography, and there was observed agreement between the two studies in 98% of all arterial segments examined. Results: Agreement between MRA and contrast arteriography was uniform for arterial segments below th e inguinal ligament. Intraoperative findings and favorable early resul ts of seven bypass grafts performed in six patients after MRA alone su ggested this was a valid approach for patients at prohibitive risk of complications from contrast arteriography. Conclusions: Magnetic reson ance angiography is accurate in demonstrating relevant anatomy in peri pheral arterial occlusive disease and in selected patients may elimina te the need for contrast arteriography before lower extremity revascul arization.