Contrast-Enhanced Magnetic Resonance Angiography Following Subintimal Recanalization

• Published in: Vascular and endovascular surgery 2010-04, Vol.44 (3), p.223-231
• Main Authors: Abdel-Gawad, Ehab, Harthun, Nancy, Norton, Patrick, Bonatti, Hugo, Turba, Ulku, Spinosa, David J., Bozlar, Ugur, Ramkaransingh, Jeffrey R., Hagspiel, Klaus D.
• Format: Article
• Language: English
• Subjects: Aged; Aged, 80 and over; Angiography, Digital Subtraction; Arterial Occlusive Diseases - diagnosis; Arterial Occlusive Diseases - physiopathology; Arterial Occlusive Diseases - surgery; Biological and medical sciences; Cardiovascular system; Constriction, Pathologic; Contrast Media; Female; Gadolinium DTPA; Humans; Imaging, Three-Dimensional; Investigative techniques, diagnostic techniques (general aspects); Lower Extremity - blood supply; Magnetic Resonance Angiography - methods; Male; Medical sciences; Predictive Value of Tests; Radiodiagnosis. Nmr imagery. Nmr spectrometry; Recurrence; Retrospective Studies; Severity of Illness Index; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Time Factors; Treatment Outcome; Vascular Patency; Vascular surgery: aorta, extremities, vena cava. Surgery of the lymphatic vessels; Vascular Surgical Procedures
• ISSN: 1538-5744; 1938-9116
• DOI: 10.1177/1538574410362110

Purpose: To describe the appearance of lower extremity runoff vessels following subintimal recanalization (SIR) on contrast-enhanced magnetic resonance angiography (ceMRA) and compare 2 different ceMRA techniques. Methods: A total of 6 patients underwent stepping table 3-dimensional (3D) ceMRA and time-resolved 2-dimensional (2D) MRA within 1 to 3 days (mean 1.83 days) following SIR. The 2 techniques were compared with intra-arterial digital subtraction angiography (DSA). Results: A total of 15 arteries were recanalized in 6 patients. Three-dimensional ceMRA allowed evaluation of patency in all segments above the knee. Postprocedural hyperemia impaired the assessment of the trifurcation vessels on 3D ceMRA. Due to its higher temporal resolution 2D MRA was not affected by venous contamination and allowed reliable confirmation of patency of the recanalized vessels. Conclusions: Diagnostic MRA studies of the lower extremity runoff vessels following SIR is possible, but a hybrid technique using a stepping table MR DSA and a time-resolved sequence like 2D MRA of the calf station is necessary for runoff assessment.