الفهرس 
Natural History and main consequences of AtherosclerosisOnly 14 pages are availabe for public view
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Abstract
The new clinical entity, known as aorto-iliac atherosclerosis obliterans or aorto-iliac occlusive disease (AIOD), is one of the most frequent clinical problems confronted by vascular surgeons today. The abdominal aorta and iliac arteries being amongst the arterial segments most commonly affected by atherosclerosis. Digital subtraction angiography was considered the gold standard technique in assessment of these arteries. The major advantage of DSA were high spatial resolution images and temporal information regarding delayed filling of the vasculature of interest. However, the invasiveness of the procedure, and radiation exposure led to the need for less and non-invasive imaging techniques. CT angiography has been shown to be accurate in the investigation of a number of diseases, but long gantry rotation periods and slow table speed limited the performance of CT angiography with single-detector scanners to relatively small anatomical areas. Multi-detector row CT scanners (MDCT) allow imaging over cranio-caudal lengths exceeding 1.5 meter. Imaging of the entire arterial supply of the lower extremities in a single helical acquisition is possible by MDCT. The aim of this study is to evaluate the role of MDCT angiography as a recent less invasive technique for investigating aortoiliac arterial disease with does, time and contrast reduction. This study included 30 patients (24 males & 6 females) with an age range of 33 – 75 years. All of these patients underwent MDCT angiography. The aortoiliac arteries were divided into 18 arterial segments. Each segment was evaluated and given a grade from 0 to 4 according to its appearance in the MDCT. The sensitivity of MDCT angiography in this study was 98.7% in determine arterial stenosis and occlusion while the sensitivity for calcium detection is 100%. MDCT angiography has proved to be a less invasive and a reliable method of investigating the aortoiliac arterial disease. MDCT angiography as a less invasive imaging modality may be used for preoperative assessment of aortoiliac arterial disease. Conventional angiography may be spared for patients who are candidate for interventional procedures (e.g. angioplasty or stent application). Color coded Doppler is also a reliable non-invasive method of investigating the aortoiliac arterial system. It has an advantage over conventional angiography that it provides us with data about the velocity of blood distal to the obstruction and shape of the waveform that adds more to determining the hemodynamic significance of this lesion. The limiting factor for CCD imaging is that this examination is totally operator dependent. It requires highly trained personnel which is not always available. It also lacks the arterial imaging capabilities of MDCT angiography that surgeons need for preoperative planning.