CT ANGIOGRAPHY LOWER LIMBS

CT ANGIOGRAPHY LOWER LIMB

ct angio lower limb indications

Lower extremity trauma
- High risk injuries include – distal segmental femoral fractures, high energy tibial plateau fractures, displaced distal femoral fractures at the adductor hiatus, open femoral or tibial fractures, knee dislocation.
- Arterial laceration, occlusion, dissection or AV fistula/aneurysm formation.
Pulsatile haemorrhage, expanding haematoma, palpable thrill, audible bruit, pulseless limb - initial imaging
Peripheral arterial disease - claudication, tissue loss, ulceration, revascularisation assessment- initial imaging
Fibromuscular dysplasia, non- inflammatory vascular disease, connective tissue vascular disease, vasculitis
Popliteal arterial entrapment syndrome
Clinically suspected vascular malformation of the lower extremity
Post-operative arterial pseudoaneursym
External iliac endofibrosis suspected

ct angio lower limb pt prep

Patient able to lie still for ten minutes
Not claustrophobic (sedation may be given)
Cognitively capable of following basic instructions
Metal artefacts removed from the region of interest
No respiratory distress when lying supine
Not allergic to Iodine based contrast
No known kidney disease (eGFR below 30 as per RANZCR), however, acute setting consultant may sign to continue with poor renal function
No hyperthyroidism, may induce thyroid storm
Patient to have 18G cannula in anterior cubital fossa to enable a 7ml/s flow rate (20G cannula acceptable if flushing to 5ml/s).
Preferably patient fasted for 4 hours

ct angio lower limb anatomy

Patterson et al., 2016 - Clinical indications for CT angiography in lower extremity trauma, Current Orthopaedic Practice 27(4):p 400-404
American College of Radiology (ACR). Appropriateness Criteria. [Internet]. 2022 [Updated 2023, Cited 20 Feb 2024]. Available from https://www.acr.org/Clinical-Resources/ACR-Appropriateness-Criteria