Overall image quality and specificity of QISS-MRA at 3T are diminished relative to CE-MRA. However, when image quality is adequate, QISS-MRA has high sensitivity and, thus, has potential use in patients with contraindications to gadolinium.

The poor general condition of the patient requires a sufficient interdisciplinary preoperative planning. By means of interdisciplinary cooperation, the limbs can be salvaged. This not only improves the quality of life but also increases the survival time of patients with occlusive vascular disease. Different concepts for this group of patients have been developed. Surgical treatment with a distal bypass or recanalisation and free flap not only allow for the coverage of large defects, but also represent a haemodynamic advantage by increased blood flow in the bypass. This is attributed to the additional vascular bed that is transplanted with the free flap. Limb salvage means relevant improvement, however, the initially less demanding procedure of amputation must always be considered.