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CTA Runoff (Vasculature, lower extremity)

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Basics: What is CTA Runoff?

CTA stands for Computed Tomography Angiography, and is done with a cat scan machine. Runoff refers to the traditional invasive study, conventional angiography, where a catheter is placed in the lower abdominal aorta via an artery at the groin (common femoral artery), and pictures are taken of the arteries in the upper and lower legs, down to the feet. Either the table the patient was lying on, or the overlying camera moved to visualize the “Runoff” of dye or contrast going down the legs. CTA runoff, therefore, obtains pictures of the arteries in the legs, noninvasively, and using a state of the art CT machine.

The latest in CT “scanners”, are called 64-slice detector scanners, and obtain phenomenal pictures of the arteries. There is no longer any reason for performing a conventional invasive angiography, unless the physician has planned on going in to fix something specific. If your doctor is simply trying to assess any narrowing of arteries in your legs, make sure to request that they do a CT or Cat Scan, as opposed to an angiogram.

At Siker Medical, we are extremely experienced in this technique, and because we also have extensive experience in the traditional angiograms, we are very knowledgeable in terms of reading and interpreting these studies.

CTA is considered medically necessary for any of the following indications of the pelvis or lower extremities:

• For the pre-operative evaluation of aortoiliac occlusion or peripheral vascular disease of the leg, especially when there are contraindications to conventional arteriography and ultrasound has indicated significant disease, but was inconclusive regarding the pathology, in terms of whether it would be amenable to surgery.
• Assessment of significant ischemia in the presence of ulcers or gangrene or symptoms of significant claudication.
• Assessment of disease of large vessels: aneurysm, dissection, AV malformations and fistulas, intramural hematoma, vasculitis
• Arterial entrapment syndrome.
• Venous thrombosis, if diagnosis is not clear from other studies.
• Vascular invasion or displacement by tumor.
• Pre/Post-operative or interventional vascular procedure for luminal patency versus re-stenosis (due to atherosclerosis, thromboembolism, intimal hyperplasia and other causes) as well as complications such as pseudoaneurysms related to:

- Surgical bypass grafts.
- Vascular stents and stent-grafts.

Discussion of images above:

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1. Occluded right superficial femoral artery with evidence of a previous SFA stent. Modest collaterals reconstitute the right distal SFA/popliteal junction with good three-vessel runoff to the right ankle.
2. Mild to moderate atherosclerotic changes of the left lower extremity including the left distal external iliac artery, with wide patency of the main arterial vessels, and good three-vessel run off to the ankle.
3. Widely patent renal and visceral arteries of the abdomen.

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1. Occluded right superficial femoral artery with evidence of a previous SFA stent. Modest collaterals reconstitute the right distal SFA/popliteal junction with good three-vessel runoff to the right ankle.
2. Mild to moderate atherosclerotic changes of the left lower extremity including the left distal external iliac artery, with wide patency of the main arterial vessels, and good three-vessel run off to the ankle.

 

 

 

Women's Imaging
Dr. Amy Thurmond Woman's Imaging and Interventional Radiology

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