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New Imaging Techniques and Arterial Disease

The correct diagnosis and treatment of arterial disease requires precise information about the site, extent and haemodynamic effect of any abnormality. The mainstay of vascular imaging today is the percutaneous angiogram. This is Widely available, including out of normal working hours, and may be followed by a therapeutic manoeuvre, i.e. dissolution therapy in the acute arterial occlusion or angioplasty for localized arterial insufficiency. Where digital subtraction angiography (DSA) is available, images of high quality may be obtained with smaller gauge catheters and reduced volume contrast injections leading to a reduction in patient risk and the introduction of 'day case' arteriography. Much of the present practice of vascular surgery has been created around the insights given by angiography into arterial disease. If new vascular imaging technologies are to be introduced, it must be on the basis that some of the technical and logistic difficulties of angiography can be overcome without compromising (or even better enhancing) the practice of vascular surgery. There are two noninvasive imaging modalities which in recent years have significantly improved