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Multidetector CT Angiography of Infrainguinal Arterial Bypass¹

¹ From the Department of Radiology, University of Texas Southwestern Medical Center, Dallas (J.E.L., C.K.T., S.G.J., M.E.A., S.S., R.L., B.D.), and the Department of Vascular Surgery, University of Texas Health Science Center at San Antonio (B.T.). Presented as an education exhibit at the 2006 RSNA Annual Meeting. Received February 26, 2007; revision requested June 11 and received July 26; accepted August 27. All authors have no financial relationships to disclose. Address correspondence to J.E.L., Department of Radiology, University of Texas Health Science Center, 7703 Floyd Curl Dr, San Antonio, TX 78229 (e-mail: Lopera{at}uthscsa.edu).

Infrainguinal arterial bypass (IGAB) surgery is commonly performed in patients with claudication, critical limb ischemia, or other arterial problems in the lower extremities. An IGAB is constructed from different materials depending on the anatomy of the lesion and the availability of an autogenous vein. The ideal material for IGAB is the greater saphenous vein, especially for distal below-knee bypass. In patients with no available autogenous vein, IGAB can be performed by using different prosthetic materials or biologic grafts. After the surgery, periodic surveillance is performed with duplex ultrasonography and clinical assessment of peripheral pulses and ankle-brachial indexes. If complications are detected, further work-up is performed with conventional arteriography, multidetector computed tomographic (CT) angiography, or magnetic resonance angiography. CT angiography has become a powerful tool for assessing the potential early and late complications of IGAB and for planning further therapy in a fast, reliable, and noninvasive manner.

© RSNA, 2008

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