Peripheral arterial occlusive disease caused by atherosclerosis can present with intermittent claudication or critical limb ischemia. Proper diagnosis and management is warranted to improve symptoms and salvage limbs. With the introduction of new techniques and dedicated materials, endovascular recanalization is widely performed for the treatment of peripheral arterial occlusive disease because it is less invasive than surgery. However, there are various opinions regarding the appropriate indications and procedure methods for interventional recanalization according to operator and institution in Korea. Therefore, we intend to provide evidence based guidelines for interventional recanalization by multidisciplinary consensus. These guidelines are the result of a close collaboration between physicians from many different areas of expertise including interventional radiology, interventional cardiology, and vascular surgery. The goal of these guidelines is to ensure better treatment, to serve as a guide to the clinician, and consequently, to contribute to public health care.
Arterial Occlusive Diseases/radiography/*therapy ; Arteries/pathology ; Endovascular Procedures/*standards ; Humans ; Intermittent Claudication/radiography/therapy ; Limb Salvage/methods ; Lower Extremity/*blood supply ; Peripheral Arterial Disease/radiography/*therapy ; *Practice Guidelines as Topic ; Republic of Korea

OBJECTIVE: To investigate the validity of the 100 kVp setting in CT venography (CTV) in the diagnosis of deep vein thrombosis (DVT), and to evaluate the feasibility of reducing the amount of administered iodine in this setting. MATERIALS AND METHODS: After receiving the contrast medium (CM) of 2.0 mL/kg, 88 patients underwent CTV of the pelvis and lower extremities by using one of four protocols: Group A, 120 kVp setting and 370 mgI/mL CM; group B, 120 kVp and 300 mgI/mL; group C, 100 kVp and 370 mgI/mL; group D, 100 kVp and 300 mgI/mL. The groups were evaluated for venous attenuation, vein-to-muscle contrast-to-noise ratio (CNRVEIN), DVT-to-vein contrast-to-noise ratio (CNRDVT), and subjective degree of venous enhancement and image quality. RESULTS: Venous attenuation and CNRVEIN were significantly higher in group C (144.3 Hounsfield unit [HU] and 11.9), but there was no significant difference between group A (118.0 HU and 8.2) and D (122.4 HU and 7.9). The attenuation value of DVT was not significantly different among the four groups, and group C had a higher absolute CNRDVT than the other groups. The overall diagnostic image quality and venous enhancement were significantly higher in group C, but there was no difference between groups A and D. CONCLUSION: The 100 kVp setting in CTV substantially help improve venous enhancement and CNRVEIN. Furthermore, it enables to reduce the amount of administered iodine while maintaining venous attenuation, as compared with the 120 kVp setting.
Contrast Media/administration & dosage ; Feasibility Studies ; Female ; Humans ; Iohexol/administration & dosage/analogs & derivatives ; Linear Models ; Lower Extremity/blood supply/*radiography ; Male ; Middle Aged ; Phantoms, Imaging ; Phlebography/*methods ; Statistics, Nonparametric ; Tomography, X-Ray Computed/*methods ; Venous Thrombosis/*radiography