Predicted hyperemic angiography: a technique of distal arteriography in the severely ischemic leg.

A technique of distal arteriography in the severely ischemic leg has been developed by modifying hyperemic angiography. The postischemic hyperemic response can be measured for a given patient and the time fo maximum glow predicted. A study of 35 patients with severe ischemia has shown the maximum hyperemic response time (MHRT) to vary greatly among patients. Knowing the specific MHRT in advance has enabled us to inject contrast during maximum flow periods. The resulting predicted hyperemic angiograms provided visualization of the pedal arch in four extremities not visualized by conventional angiography. Predicted hyperemic angiography appears to provide a means of evaluating calf and pedal circulations in severely ischemic legs prior to surgery.