References | Advised 1st choice investigation method | Advantages of CTA | Disadvantages of CTA |
Ikuo Fukuda (2015) Japan | CTA or Doppler Ultrasound | Availability and scan timing Accurate | Radiation exposure Nephrotoxic |
S Puppala (2009) UK | CTA is described as a “clinical tool” for the evaluation of the arterial system. Imaging should be used in Rutherford classification I - IIa; Revascularisation if Rutherford classification more than IIb | Availability out-of-hours and scan timing Accurate—0.6-millimetre slices and 3D reconstruction Can be used if MRA is contraindicated Additional information on structural anatomy | Radiation exposure Iodinated contrast allergy False-positive due to vessels calcification. False-positive due to unopacified vessels with the contrast (contrast timing) |
Alex Wallace (2019) USA | Authors preference is CTA for ALI Rutherford classification I - IIa and in some cases IIb. | Non-invasive Available Accurate—0.6-millimetre slices and 3D reconstruction Extravascular findings Preoperative planning | Radiation exposure Nephrotoxic Contraindicated if eGFR less than 30 mL/min. False-positive results due to vessels calcification (over staging 8%, under-staging 15%) or unopacified vessels with the contrast |
Anthony N. Hage (2018) USA | CTA for ALI Rutherford classification I - IIa and in some cases IIb. | Non-invasive Accurate—High resolution imaging Preoperative planning | - |
Charles Gilliland (2017) USA | The authors “favoured” choice of imaging is CTA. | Preoperative planning | - |
M. Duran (2016) Germany | Doppler for ALI Rutherford classification I - II DSA | Available and scan timing Helps to make definitive management | - |
M. Duran (2017) Germany | Doppler and CTA | Available and scan timing Helps to make definitive management | - |
T. Gregory (2009) USA | Doppler or DSA for ALI Rutherford classification I - IIa, in some cases IIb | - | Radiation exposure Use of ionizing contrast Fail to visualise target vessels |
Andrew Nickinson (2018) UK | CTA | Non-invasive Availability Accurate—High resolution imaging | Nephrotoxicity |
Dan-Mircea Olinic (2019) Romania | Doppler—1st imaging choice for Rutherford classification I - IIa DSA—“gold standard” | Non-invasive Accurate—High resolution imaging | Contraindicated if eGFR less than 60 mL/min. Nephrotoxicity |
Balaji Natarajan (2020) USA | Doppler—1st imaging choice DSA—“gold standard”. | Availability and scan timing Accurate—3D resolution Preoperative planning Sensitivity 91% - 100% Specificity 93% - 96% | Allergy to ionizing contrast Contraindications, such as chronic kidney disease Nephrotoxicity |
Martin Bjorck (2020) UK | DSA—“gold standard” | Availability Accurate—High resolution imaging Extravascular findings Preoperative planning | Nephrotoxicity Contraindicated with eGFR less than 30 mL/min Delay in treatment |
Clifford R. Weiss (2017) USA | DSA—“gold standard” | Noni-invasive Accurate—multidetector-row resolution Affordability—cost-effectiveness Can be used in patients with MRA contraindications Reduced radiation dosages for a single CTA examination | Radiation exposure Contraindication if eFDR less than 45 mL/min Nephrotoxicity Poor visualisation of heavily calcified vessels |
Yaseen Oweis (2016) USA | - | Availability Accuracy Preoperative planning | Nephrotoxicity False-positive due to unopacified vessels with the contrast False-positive results die to vessels calcification Extravascular findings can be missed |