Comparison of Contrast-Enhanced Magnetic Resonance Angiography and Digital Subtraction Angiography in Patients With Chronic Critical Ischemia and Tissue Loss

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Abstract
To compare the ability of intra-arterial digital subtraction angiography (IA-DSA) and total runoff contrast-enhanced magnetic resonance angiography (CE-MRA) to demonstrate peripheral arterial anatomy, specifically in patients with chronic critical ischemia and tissue loss. Twenty-three consecutive patients with chronic critical ischemia and tissue loss underwent CE-MRA and IA-DSA within 2 days. Two teams, consisting of an interventional radiologist and vascular surgeon who were blinded to each other's results, determined the number of named arteries (21 segments) and the presence of ≥50% stenosis or occlusion. Compared with IA-DSA, both teams detected significantly more arterial segments with CE-MRA, both above and below the knee (team 1: above knee 7.0 versus 5.2, P = 0.002, and below knee 8.5 versus 5.4, P P In the present study CE-MRA detected more patent arteries than IA-DSA in patients with chronic critical ischemia and tissue loss. CE-MRA can modify the choice of therapeutic strategy in these patients.