Current optimal morphological evaluation of peripheral arterial diseases

Imaging plays a central role in the management of peripheral arterial diseases (PAD), emphasized by the continuously increasing use of modern cross-sectional imaging and the corresponding decline of digital subtraction angiography (DSA) in the diagnostic setting. Imaging is sometimes used as a screening tool in highrisk individuals. In symptomatic patients, imaging is mandatory to make an accurate positive diagnosis, grade the severity and the extent of the abnormalities, carefully choose and plan the best therapeutic option and provide adequate follow-up. Non-invasive diagnosis of PAD can be made by Doppler ultrasonography, magnetic resonance angiography (MRA) and computed tomography angiography (CTA). Given the major technological breakouts over the last decade, MRA and especially CTA are nowadays mature and precise enough to properly answer all the questions raised in symptomatic patients. This review article aims at describing state-of-the-art non-invasive imaging of PAD, its involvement in the decision-making for the vascular surgeon and the future trends and developments expected in the coming years.