Management of peripheral arterial disease: Role of computed tomography angiography and magnetic resonance angiography

The recent technological developments of CT and MR units enable fast angiographic acquisitions with an improved spatial and temporal resolution. With advanced 3D visualisation, image post-processing and vessel wall-imaging, these technologies are now almost replacing diagnostic angiography that is now mainly indicated in case of suboptimal computed tomography angiography (CTA) or magnetic resonance angiography (MRA) examinations. Catheter angiography is now used to guide endovascular therapy and the planning of endovascular intervention will rely mainly on CTA or MRA examinations. The relative indications of MRA and CTA for the assessment and follow-up of peripheral arterial disease are based on the clinical indication, potential contraindication and the accessibility. We will review in this chapter, the technical requirements to perform adequate CTA and MRA examination, the relative indications of both modalities for the diagnosis and management of peripheral arterial occlusive disease (PAOD) and abdominal and peripheral aneurysm diseases. The main imaging features observed in these patients will be detailed.