The Comparative Study Of Multi-Slices Spiral CT Angiography With DSA And Interventional Therapy In Lower Extremity Arteriosclerosis Obliterans

ObjectTo evaluate the clinical application of multi-slice Spiral CT angiography (MSCTA)Technique for diagnosis of the lower extremity arteriosclerosis obliterans (ASO). To determine the safety, efficacy, and mid-short term results of percutaneous transluminal angioplasty(PTA)in the patients with lower extremity arteriosclerosis obliterans.MethodsThe data on medical history and postoperative follow-up of 56 patients with lower extremity ASO from April 2009 to March 2010 were analyzed retrospectively. The arteries treated with angioplasty was divided into the above-the-knee group (atk group)and below-the-knee group (btk group), comparative study of the DSA and CTA data.Type and conduct cases in vascular surgery group were observed. The preoperative and Postoperative ankle-brachial index, surgical successful rate, complication rate and postoperative cumulative unblocked rate at different times limb salvage rate and survival rate were observed.ResultsThe quality of source and post-processing images are satisfactory in all 38 patients who underwent CTA examination. Using the DSA images as the standard reference, the coincidence of MSCTA were 98.03%, the rates of sensitivity, specificity, and accuracy of MSCTA were 93.7%,99.2%,98.0% respectively, and the positive predictive value and negative predictive value were 96.7%,98.4% respectively. The rates of technical success of PTA plus stent, clinical success, and perioperative complication were 98.2%,94.6% and 5.4% respectively.There was no death in 56 patients.The ankle-brachial index after operation was significantly higher than that before operation (P<0.001). The average time after the initial limb patency was 240 days, the cumulative patency rate was 56%±12%, The result showed that different location and TASC classification had effect on the postoperative patency rate.ConclusionsMSCTA has the same effect of with DSA in the observation and measurement of lower extremity vascular grade,site of stenosis,etc. which can replace DSA to a considerable extent.and may be used as the primary screening method for diagnosis of the arterial diseases of lower extremities. PTA is a safe, and effective procedure for the treatment of ASO, and it has a good and short-term efficacy and limb salvage rate;Different treatment sites and TASC classification have a influence on the cumulative patency rate post operatively.