Diagnostic accuracy of CT angiography for infrapopliteal lesions in patients with diabetic foot ulcers undergoing endovascular revascularization
ResumoBackground: Computed tomography angiography (CTA) is an accepted technique for selecting patients with peripheral arterial disease for surgical and endovascular treatment. There is limited data regarding its accuracy for infrapopliteal vessels in patients with diabetic foot.
Purpose: Evaluate the diagnostic accuracy of CTA for below the knee arteries in patients with diabetic foot.
Methods: Single-center retrospective analysis of CTA and Digital Subtraction Angiography imaging findings in 14 patients that underwent peripheral arterial revascularization due to diabetic foot ulcers. The sensitivity and specificity of CTA was assessed according to each arterial segment based on an adapted Rutherford Score of disease impairment.
Results: CTA overall sensitivity and specificity for the detection of significant arterial lesions was 1 (95% C.I. 0.89-1) and 0.7 (95% C.I. 0.35-0.93), respectively.
By arterial segment, the sensitivity and specificity for the anterior tibial artery were 0.96 (95% C.I. 0.88-0.99) and 0.86 (95% C.I. 0.57-0.98), for the posterior tibial artery were 0.98 (95% C.I. 0.90-0.99) and 0.93 (95% C.I. 0.66-0.99) and for the peroneal artery were 0.93 (95% C.I. 0.83-0.98) and 0.72 (95% C.I. 0.42-0.92), respectively.
Conclusion: CTA has excellent diagnostic accuracy and allows screening of diabetic patients with infrapopliteal peripheral arterial disease.
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