Influence of diabetes on diagnostic performance of computed tomography angiography of the calf arteries in acute limb ischemia
Butt, Talha LU ; Lehti, Leena LU ; Apelqvist, Jan LU ; Gottsäter, Anders LU and Acosta, Stefan LU
(2022)
In Acta Radiologica
63(5).
p.706-713
- Abstract
Background: Patients with diabetes mellitus (DM) have a more extensive distal arterial occlusive disease compared to non-diabetic patients. Diagnostic imaging is a necessity to identify the location and extent of the arterial occlusion in acute limb ischemia (ALI). Computed tomography angiography (CTA) is the most commonly used modality and the diagnostic performance with CTA of calf arteries may be questioned. Purpose: To evaluate diagnostic performance of CTA of calf arteries in ALI and to compare patients with and without DM. Material and Methods: All thrombolytic treatments performed during 2001–2008 in patients with ALI were included. Initial digital subtraction angiography (DSA) and CTA of all patients were classified according to... (More)
Background: Patients with diabetes mellitus (DM) have a more extensive distal arterial occlusive disease compared to non-diabetic patients. Diagnostic imaging is a necessity to identify the location and extent of the arterial occlusion in acute limb ischemia (ALI). Computed tomography angiography (CTA) is the most commonly used modality and the diagnostic performance with CTA of calf arteries may be questioned. Purpose: To evaluate diagnostic performance of CTA of calf arteries in ALI and to compare patients with and without DM. Material and Methods: All thrombolytic treatments performed during 2001–2008 in patients with ALI were included. Initial digital subtraction angiography (DSA) and CTA of all patients were classified according to the Inter-Society Consensus for the Management of Peripheral Arterial Disease (TASC II) below-the-knee arteries and compared to CTA. Two raters assessed the CTA images independently. Inter-rater reliability was expressed as intraclass correlation (ICC) with 95% confidence intervals (CI). Results: Patients with (n = 23) and without (n = 85) DM had lower (P = 0.006) glomerular filtration rate. ICC between CTA and DSA was 0.33 (95% CI –0.22 to 0.56) and 0.71 (95% CI 0.38–0.68) in patients with and without DM, respectively. Sensitivity with CTA for TASC D lesions in patients with and without DM was 0.14 (95% CI –0.12 to 0.40) and 0.64 (95% CI 0.48–0.80), respectively. Conclusion: The sensitivity of CTA for assessment of infra-popliteal TASC D lesions in patients with ALI was not acceptable in patients with DM in contrast to those without DM. Another imaging option at present times should be considered for patients with DM.
(Less)
- author
- Butt, Talha
LU
; Lehti, Leena
LU
; Apelqvist, Jan
LU
; Gottsäter, Anders
LU
and Acosta, Stefan
LU
- organization
- publishing date
- 2022
- type
- Contribution to journal
- publication status
- published
- subject
- keywords
- acute limb ischemia, computed tomography angiography, Diabetes mellitus, diagnostic accuracy
- in
- Acta Radiologica
- volume
- 63
- issue
- 5
- pages
- 706 - 713
- publisher
- SAGE Publications
- external identifiers
-
- pmid:33853385
- scopus:85104857424
- ISSN
- 0284-1851
- DOI
- 10.1177/02841851211006918
- language
- English
- LU publication?
- yes
- id
- 68929516-55cc-4e72-b2e2-58fb4ecf07eb
- date added to LUP
- 2021-05-17 14:05:22
- date last changed
- 2024-06-01 10:40:19
@article{68929516-55cc-4e72-b2e2-58fb4ecf07eb,
abstract = {{<p>Background: Patients with diabetes mellitus (DM) have a more extensive distal arterial occlusive disease compared to non-diabetic patients. Diagnostic imaging is a necessity to identify the location and extent of the arterial occlusion in acute limb ischemia (ALI). Computed tomography angiography (CTA) is the most commonly used modality and the diagnostic performance with CTA of calf arteries may be questioned. Purpose: To evaluate diagnostic performance of CTA of calf arteries in ALI and to compare patients with and without DM. Material and Methods: All thrombolytic treatments performed during 2001–2008 in patients with ALI were included. Initial digital subtraction angiography (DSA) and CTA of all patients were classified according to the Inter-Society Consensus for the Management of Peripheral Arterial Disease (TASC II) below-the-knee arteries and compared to CTA. Two raters assessed the CTA images independently. Inter-rater reliability was expressed as intraclass correlation (ICC) with 95% confidence intervals (CI). Results: Patients with (n = 23) and without (n = 85) DM had lower (P = 0.006) glomerular filtration rate. ICC between CTA and DSA was 0.33 (95% CI –0.22 to 0.56) and 0.71 (95% CI 0.38–0.68) in patients with and without DM, respectively. Sensitivity with CTA for TASC D lesions in patients with and without DM was 0.14 (95% CI –0.12 to 0.40) and 0.64 (95% CI 0.48–0.80), respectively. Conclusion: The sensitivity of CTA for assessment of infra-popliteal TASC D lesions in patients with ALI was not acceptable in patients with DM in contrast to those without DM. Another imaging option at present times should be considered for patients with DM.</p>}},
author = {{Butt, Talha and Lehti, Leena and Apelqvist, Jan and Gottsäter, Anders and Acosta, Stefan}},
issn = {{0284-1851}},
keywords = {{acute limb ischemia; computed tomography angiography; Diabetes mellitus; diagnostic accuracy}},
language = {{eng}},
number = {{5}},
pages = {{706--713}},
publisher = {{SAGE Publications}},
series = {{Acta Radiologica}},
title = {{Influence of diabetes on diagnostic performance of computed tomography angiography of the calf arteries in acute limb ischemia}},
url = {{http://dx.doi.org/10.1177/02841851211006918}},
doi = {{10.1177/02841851211006918}},
volume = {{63}},
year = {{2022}},
}