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Gazzetta Medica Italiana Archivio per le Scienze Mediche 2017 October;176(10):540-4

DOI: 10.23736/S0393-3660.17.03431-3

Copyright © 2017 EDIZIONI MINERVA MEDICA

language: English

Extravascular incidental findings in CT-angiography of patients with chronic lower limb ischemia

Nabil A. AL-ZOUBI 1 , Tayseer ATHAMNEH 2, Haitham QANDEEL 1, Tagleb MAZAHEH 1, Issa AL-SAMARAH 1, Abdel R. AL MANASRA 1

1 Department of Surgery, Jordan University of Science and Technology, Irbid, Jordan; 2 Princess Basma Teaching Hospital, Irbid, Jordan


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BACKGROUND: There is an increasing number of vascular surgeons who started to do endovascular interventions without interventional radiologist or checking the radiological reports. We aim to increase the awareness of vascular surgeons to the incidence and clinical relevance of extravascular incidental findings (EVIFs) in CT angiography (CTA) of the abdominal aorta and lower extremities in patients presenting with chronic lower limb ischemia (CLI).
METHODS: In this retrospective study, CTA reports conducted between 2010 and 2015 for patients presenting with clinical symptoms of CLI were reviewed. CTA reports were assessed to assign EVIFs to one of three categories of clinical relevance according to previously published studies. These categories are: (I) immediate, (II) potential, and (III) no clinical relevance.
RESULTS: CTA reports of 665 patients were analyzed. 463 (69.6%) of them were males with a mean age of 68 years. 277 out of 665 patients had EVIFs in CTA. The total number of EVIFs were 466. These 466 EVIFs were category (I) in 57 (12.3%), category (II) in 207 (44.4%) and category (III) in 202 (43.3%). Most EVIFs were located in the abdomen and pelvis in all categories. Malignancy was revealed incidentally in 9 patients.
CONCLUSIONS: EVIFs with immediate clinical relevance are common in CTA in patients presenting with CLI. Therefore, it is important to increase the awareness of vascular surgeons to review all CTA reports in order to prevent missing serious disease.


KEY WORDS: Ischemia - Lower extremity - Computed tomography angiography

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