64-section CT angiography in patients with critical limb ischaemia and severe claudication: comparison with digital subtractive angiography

Clin Radiol. 2011 Oct;66(10):945-52. doi: 10.1016/j.crad.2011.04.015. Epub 2011 Jun 11.


Aim: To assess the utility of 64 section multidetector computed tomography (MDCT) lower-limb angiography in the evaluation of patients with critical limb ischaemia (CLI) or severe intermittent claudication (IC) in grading disease before endovascular treatment.

Materials and methods: Forty-one consecutive patients with CLI or severe IC were assessed using 64 section MDCT angiography. The MDCT examinations were compared with subsequent intra-arterial digital subtraction angiography (IADSA) examinations performed at the time of endovascular intervention. The MDCT and IADSA examinations were independently scrutinized by readers blinded to the results of the other imaging method.

Results: For arterial segments with haemodynamically significant disease (stenosis ≥50%), the overall sensitivity, specificity, and accuracy of MDCT in patients with severe claudication and CLI was 99% (95% CI: 98-100%), 98% (95% CI: 97-100%) and 98% (95% CI: 97-99%), respectively. The positive predictive value (PPV) was 97% and the negative predictive value (NPV) was 99%.

Conclusions: MDCT angiography is a useful tool in the assessment of patients with severe claudication and CLI and can be reliably used to grade disease severity and plan treatment.

Publication types

  • Comparative Study
  • Evaluation Study

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Angiography, Digital Subtraction*
  • Arterial Occlusive Diseases / diagnostic imaging*
  • Arterial Occlusive Diseases / physiopathology
  • Critical Illness
  • Female
  • Humans
  • Intermittent Claudication / diagnostic imaging*
  • Intermittent Claudication / physiopathology
  • Ischemia / diagnostic imaging*
  • Ischemia / physiopathology
  • Lower Extremity / blood supply*
  • Male
  • Middle Aged
  • Predictive Value of Tests
  • Radiographic Image Interpretation, Computer-Assisted
  • Sensitivity and Specificity
  • Severity of Illness Index
  • Tomography, X-Ray Computed*