Abstract
Abstract. Peripheral arterial disease (PAD) management is exceptionally challenging. Despite advances in diagnostic and therapeutic technologies, long-term vessel patency and limb salvage rates are limited. Patients with PAD frequently require extensive workup with noninvasive tests and imaging to delineate their disease and help guide appropriate management. Ultrasound and computed tomography are commonly ordered in the workup of PAD. Magnetic resonance imaging (MRI), on the other hand, is less often acknowledged as a useful tool in this disease. Nevertheless, MRI is an important test that can effectively characterize atherosclerotic plaque, assess vessel patency in highly calcified disease, and measure lower extremity perfusion.
Literature
Critical issues in peripheral arterial disease detection and management: a call to action. Arch Intern Med. 2003;163(8):884–92.
Epidemiology of Peripheral Artery Disease. Circ Res. 2015;116(9):1509.
.2016 AHA/ACC Guideline on the Management of Patients With Lower Extremity Peripheral Artery Disease: Executive Summary: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. J Am Coll Cardiol. 2017;69(11):1465–508.
Noninvasive Physiologic Vascular Studies: A Guide to Diagnosing Peripheral Arterial Disease. Radiographics. 2017;37(1):345–56.
.Novel applications of contrast-enhanced ultrasound imaging in vascular medicine. Vasa. 2013;42(1):17–31.
Assessment of microcirculation by contrast-enhanced ultrasound: a new approach in vascular medicine. Swiss Med Wkly. 2015;145:w14047.
Is contrast enhanced ultrasonography a useful tool for the evaluation of muscular microcirculation in patients with critical limb ischaemia? Vasa. 2017;46(5):389–94.
Accuracy of Duplex Ultrasonography in Estimation of Severity of Peripheral Vascular Disease. Int J Angiol. 2013;22(3):155–8.
.Duplex criteria for determination of in-stent stenosis after angioplasty and stenting of the superficial femoral artery. J Vasc Surg. 2009;49(1):133–9.
.Three-dimensional Ultrasound Improves the Accuracy of Diameter Measurement of the Residual Sac in EVAR Patients. Eur J Vasc Endovasc Surg. 2013;46(5):525–32.
Nephrogenic systemic fibrosis: a serious late adverse reaction to gadodiamide. Eur Radiol. 2006;16(12):2619–21.
.Nephrogenic systemic fibrosis: suspected causative role of gadodiamide used for contrast-enhanced magnetic resonance imaging. J Am Soc Nephrol. 2006;17(9):2359–62.
Gadodiamide-associated nephrogenic systemic fibrosis: why radiologists should be concerned. AJR Am J Roentgenol. 2007;188(2):586–92.
.Low Risk for Nephrogenic Systemic Fibrosis in Nondialysis Patients Who Have Chronic Kidney Disease and Are Investigated with Gadolinium-Enhanced Magnetic Resonance Imaging. Clin J Am Soc Nephrol. 2010;5(3):484–9.
Nephrogenic systemic fibrosis. Vasa. 2009;38(1):31–8.
.Increasing feasibility and patient comfort of MRI in children with juvenile idiopathic arthritis. Pediatr Radiol. 2012;42(4):440–8.
.DC. Claustrophobia during magnetic resonance imaging: Cohort study in over 55,000 patients. J Magn Reson Imaging. 2007;26(5):1322–7.
.CT and MRI early vessel signs reflect clot compsition in acute stroke. Stroke. 2011;42(5):1237–43.
What are the basic concepts of temporal, contrast, and spatial resolution in cardiac CT? J Cardiovasc Comput Tomogr. 2009;3(6):403–8.
.Comparison of CT and MR angiography in evaluation of peripheral arterial disease before endovascular intervention. Acta Radiol. 2015;57(5):547–56.
Quiescent-interval single-shot unenhanced magnetic resonance angiography of peripheral vascular disease: Technical considerations and clinical feasibility. Magn Reson Med. 2010;63(4):951–8.
.Accuracy of Noncontrast Quiescent-Interval Single-Shot Lower Extremity MR Angiography Versus CT Angiography for Diagnosis of Peripheral Artery Disease: Comparison With Digital Subtraction Angiography. JACC Cardiovasc Imaging. 2017;10(10 Pt A):1116–24.
Non-contrast enhanced MR angiography: established techniques. J Magn Reson Imaging. 2012;35(1):1–19.
.ECG-triggered non-enhanced MR angiography of peripheral arteries in comparison to DSA in patients with peripheral artery occlusive disease. MAGMA. 2013;26(3):271–80.
Retrograde pedal access for patients with critical limb ischemia. J Vasc Surg. 2014;60(2):375–82.
.Transpedal Access for the Management of Complex Peripheral Artery Disease. J Invasive Cardiol. 2017;29(12):425–9.
Endovascular Revascularization of Below-the-Knee Arteries: Prospective Short-Term Angiographic and Clinical Follow-Up. J Vasc Interv Radiol. 2011;22(12):1665–73.
.Below-knee endovascular interventions have better outcomes compared to open bypass for patients with critical limb ischemia. Vasc Med. 2017;22(1):28–34.
Inter-Society Consensus for the Management of Peripheral Arterial Disease (TASC II). Eur J Vasc Endovasc Surg. 2007;33(1, Supplement):S1–S75.
.An Update on Methods for Revascularization and Expansion of the TASC Lesion Classification to Include Below-the-Knee Arteries: A Supplement to the Inter-Society Consensus for the Management of Peripheral Arterial Disease (TASC II): The TASC Steering Comittee(*). Ann Vasc Dis. 2015;8(4):343–57.
MRI in Lower Extremity Peripheral Arterial Disease: Recent Advancements. Curr Cardiovasc Imaging Rep. 2013;6(1):55–60.
.Current techniques for MR imaging of atherosclerosis. Top Magn Reson Imaging. 2009;20(4):203–15.
.Imaging of atherosclerosis: magnetic resonance imaging. Eur Heart J. 2011;32(14):1709–19b.
.Debulking Atherectomy in the Peripheral Arteries: Is There a Role and What is the Evidence? Cardiovasc Intervent Radiol. 2017;40(7):964–77.
.Endovascular Management of the Popliteal Artery: Comparison of Atherectomy and Angioplasty. Vasc Endovascular Surg. 2010;44(1):25–31.
Effective Endovascular Treatment of Calcified Femoropopliteal Disease With Directional Atherectomy and Distal Embolic Protection: Final Results of the DEFINITIVE Ca(++) Trial. Catheter Cardiovasc Interv. 2014;84(2):236–44.
Atherectomy devices: technology update. Med Devices. 2015;8:1–10.
.Analysis of wound healing time and wound-free period as outcomes after surgical and endovascular revascularization for critical lower limb ischemia. J Vasc Surg. 2018;67(3):817–25.
Predictors of delayed wound healing after endovascular therapy of isolated infrapopliteal lesions underlying critical limb ischemia in patients with high prevalence of diabetes mellitus and hemodialysis. Eur J Vasc Endovasc Surg. 2015;49(5):565–73.
Angiosomes: how do they affect my treatment? Tech Vasc Interv Radiol. 2014;17(3):155–69.
Applications of arterial spin labeled MRI in the brain. J Magn Reson Imaging. 2012;35(5):1026–37.
.Application of BOLD Magnetic Resonance Imaging for Evaluating Regional Volumetric Foot Tissue Oxygenation: A Feasibility Study in Healthy Volunteers. Eur J Vasc Endovasc Surg. 2016;51(5):743–9.
.Assessing the end-organ in peripheral arterial occlusive disease—from contrast—enhanced ultrasound to blood-oxygen-level-dependent MR imaging. Cardiovasc Diagn Ther. 2014;4(2):165–72.
Blood Oxygenation Level-Dependent CMR-Derived Measures in Critical Limb Ischemia and Changes With Revascularization. J Am Coll Cardiol. 2016;67(4):420–31.
Correlation of muscle BOLD MRI with transcutaneous oxygen pressure for assessing microcirculation in patients with systemic sclerosis. J Magn Reson Imaging. 2013;38(4):845–51.
Correlation of skeletal muscle blood oxygenation level-dependent MRI and skin laser Doppler flowmetry in patients with systemic sclerosis. J Magn Reson Imaging. 2014;40(6):1408–13.
Blood Oxygenation Level–Dependent Magnetic Resonance Imaging of the Skeletal Muscle in Patients With Peripheral Arterial Occlusive Disease. Circulation. 2006;113(25):2929.
Blood Oxygenation Level-Dependent MRI of the Skeletal Muscle during Ischemia in Patients with Peripheral Arterial Occlusive Disease. Rofo. 2009;181(12):1157–61.
.Effects of percutaneous transluminal angioplasty on muscle BOLD-MRI in patients with peripheral arterial occlusive disease: preliminary results. Eur Radiol. 2009;19(2):509–15.
Being BOLD in Critical Limb Ischemia. J Am Coll Cardiol. 2016;67(4):432–4.
.Recent advances in magnetic resonance imaging for peripheral artery disease. Vasc Med. 2018;23(2):143–52.
.Calf muscle perfusion at peak exercise in peripheral arterial disease: measurement by first-pass contrast-enhanced magnetic resonance imaging. J Magn Reson Imaging. 2007;25(5):1013–20.
Oxygenation and flow in the limbs: Novel methods to characterize peripheral artery disease. Curr Cardiovasc Imaging Rep. 2013;6(2):150–7.
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