Using CT angiography (CTA), novel techniques such as 3-D fluoroscopy-CT fusion software have demonstrated potential to augment intraprocedural arterial navigation [8]. Investigations into combined noncontrast CT and MR angiography (MRA) fusion have also been undertaken, combining the vessel wall detail of CT with the luminal detail of MRI in preprocedural vessel mapping [9]. However, evidence remains limited for these techniques in the diagnosis of ALI. All elements are essential: 1) timing, 2) reconstructions/reformats, and 3) 3-D renderings. Standard CTs with contrast also include timing issues and reconstructions/reformats. Only in CTA, however, is 3-D rendering a required element. This corresponds to the definitions that the CMS has applied to the Current Procedural Terminology codes. Sudden Onset of Cold, Painful Leg Discussion of Procedures by Variant Variant 1: Sudden onset of cold, painful leg. Suspected vascular compromise. Initial imaging. Arteriography Lower Extremity Catheter arteriography (digital subtraction angiography [DSA]) performed with iodinated contrast remains the definitive method for anatomic evaluation of lower extremity peripheral arterial disease, providing dynamic, time- resolved evaluation of vascular anatomy and vascular flow [11]. However, noninvasive cross-sectional angiography techniques (ie, CTA and MRA) are increasingly performed to confirm disease with a high degree of accuracy before the decision to catheterize and perform angiographic intervention [12-18]. Catheter arteriography is typically performed in the intraprocedural setting for interventional planning and imaging confirmation of therapeutic objectives [19,20]. The main disadvantages of arteriography are related to the invasive nature of the procedure, which imparts risks of vascular injury, infection, bleeding, and other complications [11,21], and which may require additional interventions and prolonged hospital stay.
Sudden Onset of Cold Painful Leg. Using CT angiography (CTA), novel techniques such as 3-D fluoroscopy-CT fusion software have demonstrated potential to augment intraprocedural arterial navigation [8]. Investigations into combined noncontrast CT and MR angiography (MRA) fusion have also been undertaken, combining the vessel wall detail of CT with the luminal detail of MRI in preprocedural vessel mapping [9]. However, evidence remains limited for these techniques in the diagnosis of ALI. All elements are essential: 1) timing, 2) reconstructions/reformats, and 3) 3-D renderings. Standard CTs with contrast also include timing issues and reconstructions/reformats. Only in CTA, however, is 3-D rendering a required element. This corresponds to the definitions that the CMS has applied to the Current Procedural Terminology codes. Sudden Onset of Cold, Painful Leg Discussion of Procedures by Variant Variant 1: Sudden onset of cold, painful leg. Suspected vascular compromise. Initial imaging. Arteriography Lower Extremity Catheter arteriography (digital subtraction angiography [DSA]) performed with iodinated contrast remains the definitive method for anatomic evaluation of lower extremity peripheral arterial disease, providing dynamic, time- resolved evaluation of vascular anatomy and vascular flow [11]. However, noninvasive cross-sectional angiography techniques (ie, CTA and MRA) are increasingly performed to confirm disease with a high degree of accuracy before the decision to catheterize and perform angiographic intervention [12-18]. Catheter arteriography is typically performed in the intraprocedural setting for interventional planning and imaging confirmation of therapeutic objectives [19,20]. The main disadvantages of arteriography are related to the invasive nature of the procedure, which imparts risks of vascular injury, infection, bleeding, and other complications [11,21], and which may require additional interventions and prolonged hospital stay.