Use of intra‐arterial multi‐detector row CT angiography for the evaluation of an ischaemic limb in a patient with renal impairment

The vastly improved scanning speed and z‐axis resolution afforded by multi‐detector technology has allowed CT to refine its traditional roles and to explore many new applications in imaging. We present a case report of a patient with renal failure and an ischaemic leg, which illustrates a useful new CT vascular imaging application. By carrying out 16‐channel multi‐detector row CT angiography through a sheath introduced into the common femoral artery, we obtained a high‐quality angiographic image of the affected leg, using only 30 mL of iodinated contrast material. The examination definitively showed the number, distribution and patency of the tibial run‐off arteries, with significant influence on the patient‘s subsequent clinical management. This simple and relatively minimally invasive technique is useful in peripheral vascular imaging, when conventional CT angiography using a large volume of i.v. contrast and MR angiography are unsuitable or unavailable.