Review the most adequate CT Angiography (CTA) protocols using a 64 multislice computerized tomography scanner. Review the most adequate techniques of Digital Subtraction Angiography (DSA). Review the Radiological Anatomy of the lower limb arteries. Review the most common CTA and DSA findings associated with atherosclerotic peripheral arterial disease (PAD). Compare the performance of CTA and DSA and evaluate CTA as a treatment planning imaging technique.

Atherosclerotic PAD is a common disorder, particularly in the elderly population with cardiovascular risk factors. Traditionally, pre-treatment assessment of PAD was performed with conventional catheter angiography, however recent studies have shown that the overall diagnostic performance of CTA is almost equivalent in the detection and staging of clinically relevant PAD, allowing reliable therapeutic planning.

Retrospective study (January - August 2012) of patients who underwent lower extremity CTA and DSA at our institution. CTA protocol CT angiography was performed with a 64–detector row unit (Lightspeed VCT; GE Medical Systems, Milwaukee, Wis), from 2 cm above the origin of the celiac trunk to the foot (105-130m), by using the following parameters: collimation, 0.625 X 64 mm; gantry rotation, 0.6-0.8 second; pitch, 1; noise índex, 32; scan duration,20–35 seconds. Contrast enhancement was achieved with intravenous injection of 125 mL of nonionic iodinated...

Protocol optimization is essential for maximizing the diagnostic performance of CTA. Knowledge of the arterial anatomy of the lower extremities and of the most frequent findings in PAD is paramount for vascular and interventional radiologists. There is excellent agreement between the CTA and DSA findings. CTA allows a confident diagnosis of PAD, reliable therapeutical decision-making and procedure planning.

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