Computed Tomography Angiography of the Extremities in Emergencies

Editor's Choice – European Society for Vascular Surgery (ESVS) 2020 Clinical Practice Guidelines on the Management of Acute Limb Ischaemia

“…If the distal vessels are not well opacified (e.g., in the case of femoropopliteal aneurysm or slow flow in the setting of cardiac failure), a secondary acquisition may be necessary. 48 Current CT technology allows coverage of the entire body in a single acquisition, with short acquisition times, high resolution, and the possibility of post-processing axial images into reconstructions that provide similar accuracy to DSA images ( Fig. 5).…”

Acute Limb Ischemia Secondary to Catastrophic Massive Intracardiac Thrombus in Patient with Mitral Stenosis: A Case Report and Mini Literature Review

“…Current CTA technology enables coverage of the entire body in a single acquisition, with fast acquisition times, high resolution, and the possibility of reconstructing axial images with similar accuracy to DSA images. 33 CTA has the upper hand of allowing for evaluation of the thoracic and abdominal aorta for possible embolism sources, as well as the bowel vessels for other emboli. Extravascular abnormalities may be observed that are related to the pathogenesis of ALI or have significant clinical implications.…”

CTA Imaging of Peripheral Arterial Injuries

“…Arterial Transections represents the complete rupture of the vessel, and determines the loss of distal opacification, a massive hematoma and active bleeding [5] (Figure 3). Active arterial bleeding is visualized as contrast extravasation in the arterial phase, which enlarges in venous and delayed phases [67]. In partial transection, the arterial tear involves the three layers of the vessel wall, without affecting the entire vessel's circumference, distal opacification is appreciable although reduced luminal caliber and opacification can be detected [5,55].…”

“…Pseudoaneurysm bleeding appears as irregular, lobulated perilesional contrast blush [65,68]. Pre-exiting calcification or pseudoaneurysm should be differentiate form active bleeding; delayed phase acquisition can be useful because in active bleeding the contrast extravasation dissipates along tissue planes instead pseudoaneurysm and calcification remain stable [60,67].…”

“…Arteriovenous fistulas appear as a direct connection between arteries and veins with early venous enhancement in the arterial phase, and communicating channel with the artery can be detected [67,68,70] (Figure 7). In this case, the correct positioning with a wide field of view was not possible, causing nondiagnostic examination.…”