Diagnostic Imaging of Peripheral Arterial Disease with Multi-Detector Row Computed Tomography Angiography

Peripheral arterial disease (PAD) is in the majority of patients caused by atherosclerosis in the lower extremities distal to the aortic bifurcation. Atherosclerosis is a complex systemic, progressive and degenerative disease of the intima of the arterial wall, which affects both large and medium-sized arteries. The prevalence of symptomatic PAD is 3-5% in older adults in different Western populations (1-2). Atherosclerosis has a pre-clinical course with absence of clinical symptoms for several decades. PAD generally becomes evident with symptoms of intermittent claudication. Intermittent claudication is defined as muscle cramps in the lower limb that occur following exercise and are relieved with rest. In a minority (a quarter) of patients, the disease progresses to critical limb ischemia i.e. rest pain or tissue necrosis (3-5). The diagnosis of PAD is based on patient history and physical examination. The severity of PAD is generally classified by measuring the ankle-brachial indices.