Investigation of peripheral vascular bed in critical lower limb ischemia: comparative study between arteriography and magnetic resonance angiography

Objectives: To determine the precise role of arteriography and contrast-enh anced magnetic resonance angiography (MRA) to evaluate the peripheral vascu lar bed in critical ischemia of the lower limbs in candidates for distal va scularization. Material and methods: Fifteen patients (mean age 66 +/- 18 years) underwent MRA and arteriography. In all, 23 lower limbs were studied by non-selectiv e arteriography with aortic injection (n = 12) or selective arteriography w ith iliofemoral injection (n = 11). Results: The strength of agreement between MRA and selective arteriography was good (k = 0.75) for analysis of leg arteries. MRA was better than non-s elective arteriography (p < 0.035) to evaluate artery patency. In our study , only MRA improved the treatment decision. Conclusion: In patients requiring an assessment of the peripheral vascular bed before distal revascularization, contrast-enhanced MRA can be the first exam. In case of an inadequate MRA, only selective arteriography needs to be performed.