Presentation
40 years old male was referred for evaluation of intermittent claudication in left lower limb. He was a chronic heavy smoker.
Patient Data
CTA shows total obstruction at left external iliac artery, femoral.popliteal arteries.
Normal right side lower limb arteries.
Case Discussion
Buerger disease is an obliterative arteritis found predominantly in heavy smokers. It most commonly affects medium and small vessels of the lower extremities.
VRs allow visualization of complex, overlapping arterial channels without the need for preliminary bone removal, providing an excellent overview of the complex anatomy.
Peripheral CTA provides complete delineation of both the femoropopliteal segment and inflow and outflow arteries, including lesion number, length, stenosis diameter and morphology, adjacent normal arterial caliber, degree of calcification, and status of distal runoff vessels. These findings help in planning the procedure with respect to route of access, balloon selection, and expected long-term patency after femoropopliteal intervention. Compared with catheter angiography, peripheral CTA provides better estimates of the effects of eccentric stenoses on luminal diameter reduction . In addition, collateral vessels can be evaluated with MIP and VR images, and arterial segments distal to long-segment occlusions are well visualized peripheral CTA is more cost effective than digital subtraction angiog-raphy (DSA) for preprocedure evaluation of patients with claudication
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