• 1

    Mell M, Tefera G, Thornton F, et al: Clinical utility of time-resolved imaging of contrast kinetics (TRICKS) magnetic resonance angiography for infrageniculate arterial occlusive disease. .J Vasc Surg 45::543. ,2007. .

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 2

    Meissner OA, Rieger J, Weber C, et al: Critical limb ischemia: hybrid MR angiography compared with DSA. .Radiology 235::308. ,2005. .

  • 3

    Rofsky NM, Adelman MA: MR angiography in the evaluation of atherosclerotic peripheral vascular disease. .Radiology 214::325. ,2000. .

  • 4

    Romano M, Mainenti PP, Imbriaco M, et al: Multidetector row CT angiography of the abdominal aorta and lower extremities in patients with peripheral arterial occlusive disease: diagnostic accuracy and interobserver agreement. .Eur J Radiol 50::303. ,2004. .

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 5

    Ofer A, Nitecki SS, Linn S, et al: Multidetector CT angiography of peripheral vascular disease: a prospective comparison with intraarterial digital subtraction angiography. .AJR Am J Roentgenol 180::719. ,2003. .

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 6

    Smith DC, Yahiku PY, Maloney MD, et al: Three new low-osmolality contrast agents: a comparative study of patient discomfort. .AJNR Am J Neuroradiol 9::137. ,1988. .

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 7

    Cumberland DC: Low-osmolality contrast media in cardiac radiology. .Invest Radiol 19: (suppl):S301. ,1984. .

  • 8

    Lasser EC: Pretreatment with corticosteroids to prevent reactions to i.v. contrast material: overview and implications. .AJR Am J Roentgenol 150::257. ,1988. .

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 9

    Lasser EC, Berry CC, Talner LB, et al: Protective effects of corticosteroids in contrast material anaphylaxis. .Invest Radiol 23: (suppl 1):S193. ,1988. .

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 10

    Cochran ST: Anaphylactoid reactions to radiocontrast media. .Curr Allergy Asthma Rep 5::28. ,2005. .

  • 11

    Lasser EC: Corticosteroid prophylaxis in patients at increased risk of adverse reactions to intravascular contrast agents. .Clin Radiol 49::582. ,1994. .

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 12

    Lasser EC, Berry CC, Mishkin MM, et al: Pretreatment with corticosteroids to prevent adverse reactions to nonionic contrast media. .AJR Am J Roentgenol 162::523. ,1994. .

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 13

    Katayama H, Yamaguchi K, Kozuka T, et al: Adverse reactions to ionic and nonionic contrast media: a report from the Japanese Committee on the Safety of Contrast Media. .Radiology 175::621. ,1990. .

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 14

    Waybill MM, Waybill PN: Contrast media-induced nephrotoxicity: identification of patients at risk and algorithms for prevention. .J Vasc Interv Radiol 12::3. ,2001. .

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 15

    Parfrey PS, Griffiths SM, Barrett BJ, et al: Contrast material-induced renal failure in patients with diabetes mellitus, renal insufficiency, or both: a prospective controlled study. .N Engl J Med 320::143. ,1989. .

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 16

    Barrett BJ, Carlisle EJ: Metaanalysis of the relative nephrotoxicity of high- and low-osmolality iodinated contrast media. .Radiology 188::171. ,1993. .

  • 17

    Donadio C, Tramonti G, Lucchesi A, et al: Tubular toxicity is the main renal effect of contrast media. .Ren Fail 18::647. ,1996. .

  • 18

    Hall KA, Wong RW, Hunter GC, et al: Contrast-induced nephrotoxicity: the effects of vasodilator therapy. .J Surg Res 53::317. ,1992. .

  • 19

    Harkonen S, Kjellstrand CM: Exacerbation of diabetic renal failure following intravenous pyelography. .Am J Med 63::939. ,1977. .

  • 20

    Shieh SD, Hirsch SR, Boshell BR, et al: Low risk of contrast media-induced acute renal failure in non-azotemic type 2 diabetes mellitus. .Kidney Int 21::739. ,1982. .

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 21

    Weinrauch LA, Friedberg SR, D’Elia JA: Acute renal failure after cerebral arteriography in a diabetic patient. .Neuroradiology 12::197. ,1977. .

  • 22

    Weinrauch LA, Healy RW, Leland OS Jr, et al: Coronary angiography and acute renal failure in diabetic azotemic nephropathy. .Ann Intern Med 86::56. ,1977. .

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 23

    Thomsen HS, Morcos SK: Contrast media and the kidney: European Society of Urogenital Radiology (ESUR) guidelines. .Br J Radiol 76::513. ,2003. .

  • 24

    Mueller C, Buerkle G, Buettner HJ, et al: Prevention of contrast media-associated nephropathy: randomized comparison of 2 hydration regimens in 1620 patients undergoing coronary angioplasty. .Arch Intern Med 162::329. ,2002. .

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 25

    Solomon R, Werner C, Mann D, et al: Effects of saline, mannitol, and furosemide to prevent acute decreases in renal function induced by radiocontrast agents. .N Engl J Med 331::1416. ,1994. .

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 26

    Trivedi HS, Moore H, Nasr S, et al: A randomized prospective trial to assess the role of saline hydration on the development of contrast nephrotoxicity. .Nephron Clin Pract 93::C29. ,2003. .

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 27

    Tepel M, van der Giet M, Schwarzfeld C, et al: Prevention of radiographic-contrast-agent-induced reductions in renal function by acetylcysteine. .N Engl J Med 343::180. ,2000. .

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 28

    Seeger JM, Self S, Harward TR, et al: Carbon dioxide gas as an arterial contrast agent. .Ann Surg 217::688. ,1993. .

  • 29

    Gahlen J, Hansmann J, Schumacher H, et al: Carbon dioxide angiography for endovascular grafting in high-risk patients with infrarenal abdominal aortic aneurysms. .J Vasc Surg 33::646. ,2001. .

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 30

    Lang EV, Gossler AA, Fick LJ, et al: Carbon dioxide angiography: effect of injection parameters on bolus configuration. .J Vasc Interv Radiol 10::41. ,1999. .

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 31

    Gates J, Hartnell GG: Optimized diagnostic angiography in high-risk patients with severe peripheral vascular disease. .Radiographics 20::121. ,2000. .

  • 32

    Rubin GD: Techniques for performing multidetector-row computed tomographic angiography. .Tech Vasc Interv Radiol 4::2. ,2001. .

  • 33

    Blankensteijn JD: “Computed Tomography,” in Rutherford’s Vascular Surgery, 7th Ed, ed by CA Johnston, Saunders Elsevier, Philadelphia. ,2010. .

    • Crossref
    • Export Citation
  • 34

    Fleischmann D, Hallett RL, Rubin GD: CT angiography of peripheral arterial disease. .J Vasc Interv Radiol 17::3. ,2006. .

  • 35

    Brenner DJ, Hall EJ: Computed tomography: an increasing source of radiation exposure. .N Engl J Med 357::2277. ,2007. .

  • 36

    Prokop M: CT angiography of the abdominal arteries. .Abdom Imaging 23::462. ,1998. .

  • 37

    Litt H: “Magnetic Resonance Imaging,” in Rutherford’s Vascular Surgery, 7th Ed, ed by CA Johnston, Saunders Elsevier, Philadelphia. ,2010. .

    • Crossref
    • Export Citation
  • 38

    Meaney JF: Magnetic resonance angiography of the peripheral arteries: current status. .Eur Radiol 13::836. ,2003. .

  • 39

    Hood MN, Ho VB, Foo TK, et al: High-resolution gadolinium-enhanced 3D MRA of the infrapopliteal arteries: lessons for improving bolus-chase peripheral MRA. .Magn Reson Imaging 20::543. ,2002. .

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 40

    Sharafuddin MJ, Stolpen AH, Sun S, et al: High-resolution multiphase contrast-enhanced three-dimensional MR angiography compared with two-dimensional time-of-flight MR angiography for the identification of pedal vessels. .J Vasc Interv Radiol 13::695. ,2002. .

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 41

    Grobner T: Gadolinium: a specific trigger for the development of nephrogenic fibrosing dermopathy and nephrogenic systemic fibrosis?. Nephrol Dial Transplant 21::1104. ,2006. .

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 42

    Foo TK, Ho VB, Marcos HB, et al: MR angiography using steady-state free precession. .Magn Reson Med 48::699. ,2002. .

  • 43

    Spuentrup E, Manning WJ, Bornert P, et al: Renal arteries: navigator-gated balanced fast field-echo projection MR angiography with aortic spin labeling: initial experience. .Radiology 225::589. ,2002. .

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 44

    Miyazaki M, Takai H, Sugiura S, et al: Peripheral MR angiography: separation of arteries from veins with flow-spoiled gradient pulses in electrocardiography-triggered three-dimensional half-Fourier fast spin-echo imaging. .Radiology 227::890. ,2003. .

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 45

    Saab G, Abu-Alfa A: Nephrogenic systemic fibrosis: implications for nephrologists. .Eur J Radiol 66::208. ,2008. .

  • 46

    Broome DR: Nephrogenic systemic fibrosis associated with gadolinium based contrast agents: a summary of the medical literature reporting. .Eur J Radiol 66::230. ,2008. .

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 47

    Visser K, Kuntz KM, Donaldson MC, et al: Pretreatment imaging workup for patients with intermittent claudication: a cost-effectiveness analysis. .J Vasc Interv Radiol 14::53. ,2003. .

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 48

    Steffens JC, Schafer FK, Oberscheid B, et al: Bolus-chasing contrast-enhanced 3D MRA of the lower extremity: comparison with intraarterial DSA. .Acta Radiol 44::185. ,2003. .

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 49

    Carpenter JP, Owen RS, Baum RA, et al: Magnetic resonance angiography of peripheral runoff vessels. .J Vasc Surg 16::807. ,1992. .

  • 50

    Owen RS, Carpenter JP, Baum RA, et al: Magnetic resonance imaging of angiographically occult runoff vessels in peripheral arterial occlusive disease. .N Engl J Med 326::1577. ,1992. .

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 51

    Swan JS, Carroll TJ, Kennell TW, et al: Time-resolved three-dimensional contrast-enhanced MR angiography of the peripheral vessels. .Radiology 225::43. ,2002. .

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 52

    Proia RR, Walsh DB, Nelson PR, et al: Early results of infragenicular revascularization based solely on duplex arteriography. .J Vasc Surg 33::1165. ,2001. .

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 53

    Wilson YG, George JK, Wilkins DC, et al: Duplex assessment of run-off before femorocrural reconstruction. .Br J Surg 84::1360. ,1997. .

Arterial Imaging in Patients with Lower-extremity Ischemia and Diabetes Mellitus

Frank Pomposelli Division of Vascular and Endovascular Surgery, Beth Israel Deaconess Medical Center, 110 Francis St, Ste 5B, Boston, MA 02215. (E-mail: fpompose@bidmc.harvard.edu)

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Precise comprehensive imaging of arterial circulation is the cornerstone of successful revascularization of the ischemic extremity in patients with diabetes mellitus. Arterial imaging is challenging in these patients because the disease is often multisegmental, with a predilection for the distal tibial and peroneal arteries. Occlusive lesions and the arterial wall itself are often calcified, and patients with ischemic complications frequently have underlying renal insufficiency. Intra-arterial digital subtraction angiography, contrast-enhanced magnetic resonance angiography, and, more recently, computed tomographic angiography have been used as imaging modalities in lower-extremity ischemia. Each modality has specific advantages and shortcomings in this patient population, which are summarized and contrasted in this review. (J Am Podiatr Med Assoc 100(5): 412–423, 2010)