The Role of Imaging in Peripheral Arterial Disease

Peripheral arterial disease, specifically lower limb peripheral arterial disease, can be defined as atheromatous narrowing or occlusion of an artery or arteries in the lower limb. This is becoming an ever more present disease affecting more and more people each year. Diagnosis and prompt treatment are key as the effects of untreated peripheral arterial disease can be dire. Symptoms can range from largely asymptomatic to severe pain, ulcerations, claudication, and rest pain. Treatment is dependent upon the degree of stenosis; this makes diagnosis and visualization of the affected area key. In the past, the cornerstones for diagnosis consisted of contrast, or conventional, angiography and duplex ultrasonography. Newer imaging modalities for diagnosis have since emerged, which consist of magnetic resonance angiography and, more recently, computed tomography angiography. No modality is without fault; therefore, it will be essential to consider side effects, potential risk, and specificity and sensitivity of results, all of which will be covered in this chapter.