CT Angiogram of the Abdomen and Both Legs

This is a CT angiogram that follows the arterial blood supply in one continuous sweep, from the aorta in the abdomen down through the pelvis and both legs to the feet. Iodine contrast is injected into an arm vein and the scanner chases it down the body. It is the map surgeons use before deciding how to open a blocked leg artery.

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What it is

"Runoff" is the word vascular specialists use for where the blood goes after it leaves the aorta — down the iliac arteries into the pelvis, through the femoral arteries in the thighs, and on into the smaller vessels below the knee. This study images that whole chain at once. Contrast is injected through an IV in the arm, and the scanner is timed to capture the moment the contrast fills the arteries, moving down the body as the blood does. The code describes a study acquired both before and after contrast is given; the pre-contrast pass gives the radiologist a baseline, which matters because calcium in an artery wall and contrast inside the artery both look bright.

Why it is done

  • To map narrowed or blocked leg arteries in peripheral artery disease, when leg pain with walking or a non-healing foot wound suggests poor flow
  • To plan a treatment and choose between them — an angioplasty, a stent, or a surgical bypass all need to know exactly where the blockage starts and what vessel is open beyond it
  • To assess an aneurysm — a bulge in the aorta or an iliac artery — and its size and shape before repair
  • To check arteries after a stent or graft, or after an injury to the pelvis or leg

What to expect

Patients are usually asked not to eat for several hours beforehand, and kidney function is generally checked before iodine contrast is given. An IV goes into an arm vein. The patient lies flat on the scanner table with legs extended and stays still while the table moves through the ring; the scan itself takes only a short time, though the appointment is longer. When the contrast goes in, a warm flush through the body and a metallic taste are common and pass in under a minute. Afterward the raw images are reconstructed into three-dimensional views of the vessels, which the radiologist and the vascular surgeon read together.

Questions worth asking

  • Is the contrast material included in the price of the scan, or billed as a separate supply line?
  • Are the three-dimensional vessel reconstructions billed on top of the scan? They are sometimes a distinct charge.
  • Will bloodwork for kidney function be drawn beforehand, and is that lab charge part of this appointment or its own?
  • If a catheter angiogram or an intervention follows, will this scan still have been necessary, or is one study usually enough to plan from?

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