The results of the review suggest that CE MRA has a better overall diagnostic accuracy than CTA or DUS, and that CE MRA is generally preferred by patients over CA. Where available, CE MRA may be a viable alternative to CA.
The only controlled trial of the effectiveness of imaging procedures suggested that the results of DUS were comparable to those of CA, in terms of surgical planning and outcome. This finding conflicts with the results of diagnostic accuracy studies, which reported poor estimates of accuracy for DUS in comparison with CA.
There was insufficient evidence to evaluate the usefulness of CTA for the assessment of PAD, particularly newer techniques.
The results of the economic modelling suggest that for PAD patients for whom the whole leg is evaluated by a preoperative diagnostic test DUS dominates the other alternatives by presenting higher effectiveness at a lower cost per QALY. However, when the analysis of stenosis is limited to a section of the leg, either above the knee or below the knee, 2D TOF MRA appears to be the most cost-effective preoperative diagnostic strategy.