Lower extremity CT angiography in peripheral arterial disease: from the established approach to evolving technical developments

This review updates the case for CT angiography in peripheral arterial disease — the narrowing of arteries to the legs — emphasizing how the technique has evolved.

The authors survey lower-extremity CTA’s strengths and its newer refinements: high-resolution vessel mapping achieved with less contrast dye and lower radiation, dual-energy techniques, and structured reporting that standardizes how findings are communicated. The thrust is that CTA has matured into an efficient, detailed first-line map for diagnosing and characterizing PAD.

The practical takeaway is to favor CTA as a primary PAD imaging tool, sparing many patients invasive catheter angiography. The resistance comes from departments anchored to catheter angiography or duplex ultrasound.

We rate the evidence moderate: a broad, well-referenced (92-citation) international review, but a narrative synthesis without original data. Its clinical significance is moderate — useful for centers weighing PAD imaging strategy, though largely an update for those already using CTA rather than a practice-changing finding. (It pairs with the older Chin & Rubin PAD-CTA entry in this library, showing how far the technique has advanced.)