MRA versus angiogram for the diagnosis of peripheral arterial disease, a case report

doi:10.1016/j.thromres.2003.11.003

Thrombosis Research

Volume 112, Issues 1–2, 2003, Pages 43-45

https://doi.org/10.1016/j.thromres.2003.11.003 Get rights and content

Introduction

Symptomatic peripheral vascular disease is a rare occurrence in childhood. Possible aetiologies include: iatrogenic complications post arterial puncture, trauma related vascular damage and congenitally narrowed vessels. Limited experience and evaluation of Magnetic Resonance Angiography (MRA) compared to the “gold standard” of conventional Digital Subtraction Angiography (DSA) complicates the diagnostic process.

We present the case of a 16-year-old female with symptomatic peripheral vascular disease, where the interpretation of MRA and DSA differed significantly, greatly affecting the potential management plan.

Section snippets

Case report

Our patient presented in the early neonatal period with symptomatic complex congenital cardiac disease (Tricuspid atresia, Pulmonary atresia, right ventricular hypoplasia with ventricular septal defect). Corrective surgery involved several staged procedures, including a modified right Blalock-Taussig shunt (age 2 weeks), atrial septostomy (15 months) and finally a modified Fontan procedure (age 2 years). A total of four cardiac catheters (femoral approach, both left and right, arterial and

Discussion

There is no literature evaluating the imaging modalities available for peripheral vascular disease in children. Conventional angiography (DSA) remains the gold standard for preoperative evaluation of the peripheral arterial tree in the adult population [1]. Less invasive techniques utilising newer magnetic resonance technology are attractive in children where arterial puncture may require significant patient sedation or general anaesthesia, and has associated risks. The technology also has the