DIAGNOSTIC-VALUE OF SPIRAL-CT ANGIOGRAPHY IN COMPARISON WITH DIGITAL SUBTRACTION ANGIOGRAPHY BEFORE AND AFTER PERIPHERAL VASCULAR INTERVENTION

To evaluate spiral-computed tomography (CT) angiography in primary dia gnosis and/or in noninvasive follow-up after vascular intervention, we compared spiral-CT angiography and conventional angiography before an d after vascular intervention. Helical-CT examinations before and afte r percutaneous transluminal angioplasty (PTA) or stent implantation we re performed in 10 patients (mean age 63 years) with symptomatic perip heral arteriosclerotic disease. Stenoses were located in the iliac, fe moral, or popliteal artery. CT examinations were done with a spiral-CT in double detector technique (CT Twin, Elscint). The parameters were as follows: slice thickness: 5.5 mm, increment: 2.7 mm, pitch: 1.5, co ntrast medium: 150 mL, flow rate: 2.5 mL/second, delay: 30 seconds. Fo r evaluation, transverse planes as well as maximum intensity projectio ns and 3-D reconstructions were used. The possible scan length reached from the aortic bifurcation down to about 10 cm below the ankle trifu rcation. Preinterventional digital subtraction angiography (DSA) was s uperior to CT angiography (CTA: 94%, maximum intensity projection [MIP ] alone: 65%), although high-grade stenoses were detected by both meth ods. After intervention, a resolved stenosis and improved peripheral f low could be detected by helical-CT as well as by intraarterial angiog raphy in every patient (100%). In the primary diagnosis of vascular ch anges, intraarterial DSA remains the method of choice. Nevertheless, s piral-CT angiography shows comparable results after percutaneous inter vention and becomes a noninvasive alternative in the postinterventiona l follow-up.