Peripheral arterial disease MRI

Peripheral arterial disease Microchapters
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AHA/ACC Guidelines on Management of Lower Extremity PAD
Guidelines for Clinical Assessment of Lower Extremity PAD
Guidelines for Diagnostic Testing for suspected PAD
Guidelines for Screening for Atherosclerotic Disease in Other Vascular Beds in patients with Lower Extremity PAD
Guidelines for Medical Therapy for Lower Extremity PAD
Guidelines for Structured Exercise Therapy for Lower Extremity PAD
Guidelines for Minimizing Tissue Loss in Lower Extremity PAD
Guidelines for Revascularization of Claudication in Lower Extremity PAD
Guidelines for Management of CLI in Lower Extremity PAD
Guidelines for Management of Acute Limb Ischemial in Lower Extremity PAD
Guidelines for Longitudinal Follow-up for Lower Extremity PAD
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Editors-in-Chief: C. Michael Gibson, M.D., Beth Israel Deaconess Medical Center, Boston, MA; Robert G. Schwartz, M.D. [1], Piedmont Physical Medicine and Rehabilitation, P.A.; Associate Editor-In-Chief: Cafer Zorkun, M.D., Ph.D. [2]

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MRI

The use of cardiac MRI in peripheral arterial disease is outlined.

ACC/AHA Guidelines- ACCF/ACR/AHA/NASCI/SCMR 2010 Expert Consensus Document on Cardiovascular Magnetic Resonance (DO NOT EDIT)

“

CMR recommendations for PAD are in agreement with current guidelines and appropriate use criteria. CMR for PAD is recommended to diagnose anatomic location and degree of stenosis of PAD (Class I, Level of Evidence: A); should be performed with gadolinium enhancement (Class I, Level of Evidence: B); and is useful in selecting patients with lower extremity PAD as candidates for endovascular intervention (Class I, Level of Evidence: A). CMR of the extremities may be considered to select patients with lower extremity PAD as candidates for surgical bypass and to select the sites of surgical anastomosis (Class IIb, Level of Evidence: B); and for post-revascularization (endovascular and surgical bypass) surveillance in patients with lower extremity PAD (Class IIb, Level of Evidence: B). Additionally, MRA of the lower extremities is appropriate for patients with claudication.

”

• Magnetic resonance angiography is the most sensitive modality to make this diagnosis of PVD.
• Magnetic resonance angiography
  • Benefits:
    • Useful to asses PAD anatomy and presence of significant stenoses
    • Useful to select patients who are candidates for endovascular or surgical revascularization
  • Limitations:
    • Tends to overestimate the degree of stenosis
    • May be inaccurate in arteries treated with metal stents
    • Can not be used in patients with contraindications to the magnetic resonance technique
• Contrast angiography

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