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from Section 11 - Surgical radiology
Published online by Cambridge University Press: 05 July 2015
Introduction
‘This is a CT angiogram, in axial/coronal/sagittal view of lower limb arteries’
Summary
A Arterial anatomy
B Blockage
C Contrast extravasation
D Dissection
E Extra-arterial – bone and soft tissue
F Flow improvements: stents, bypasses
Checklist
Arterial anatomy
• Aorta:
• divisions : single and bilateral
• Iliac:
• internal
• external
• Femoral:
• common
• profunda
• superficial
• popliteal
• Run-offs:
• anterior tibial (AT)
• posterior tibial (PT)
• peroneal
Blockage
• Filling defect: stenosis or occlusion
• Collaterals
• Calcification
Contrast extravasation
• Intramural
• Extramural
Dissection
Extra-arterial
• Bone:
• fractures, osteomyelitis secondary to amputation or vascular ulcers
• Soft tissue:
• ulcers, cellulitis, collections
Flow improvements
• Bypasses: vein vs. prosthetic; patent vs. blocked
• Stents
Look for associated pathology
• Bony fracture and soft tissue haematomas, foreign body, gas (trauma or infection)
• Metallic mesh: arterial stents
• High concentration arterial calcification: arteriosclerosis
Tips
It is essential to know normal vascular limb anatomy.
Compare one limb to the other to identify pathology.
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