Three-dimensional angio-computed tomography. New technique for imaging the acetabulum and adjacent vessels in a patient with acetabular protrusio.

An arterial injury is an infrequent but potentially lethel occurrence after primary or revision total hip arthroplasty complicated by an acetabular protrusio. Frequently, a plain radiograph and an arteriogram are used to assess the major arteries around the hip. The limitations of these techniques are well documented. A novel technique for documenting the spatial relationships of the external iliac and common femoral arteries to the acetabulum employs an arterial study combined with a three-dimensional computed scan. An angiocatheter is inserted by conventional radiographic technique and a standard computed scan with 3-mm sections is obtained and reconstructed to a three-dimensional image. The scan provides an accurate three-dimensional image of the osseous architecture and arterial images around the acetabulum. Even in the presence of a metallic arthroplastic component, the resolution of the three-dimensional angio-computed scan is sufficient to identify the external iliac artery adjacent to the pelvis.