Abstract
Acute arterial occlusion of the lower extremities is a medical emergency, usually requiring catheter thrombectomy to achieve remission. However, in certain pathological conditions it may be difficult to determine the need for additional treatment such as bypass grafting. We attempted to select treatment strategies using multidetector-row CT (MDCT) scanning. We report 2 cases. The first patient was given a diagnosis of superficial femoral artery embolism which was determined to be treatable by catheter thrombectomy alone. In the second patient a diagnosis of arteriosclerosis obliterans of the iliac artery was made, with embolic occlusion extending to the popliteal artery caused by thrombosis in the obstructed area of the iliac artery and which we determined required a femoral-femoral arterial bypass. Both patients were successfully treated by surgical procedures determined by MDCT. MDCT is a rapid, minimally invasive method, which is also useful for assessing vessel wall condition and also detecting other lesions. Its use in the differentiation of causes of acute arterial occlusion of the lower extremities, and the selection of optimal treatment strategies for improving blood flow can contribute to further improvement of limb salvage rates and prognoses.
