Usefulness of the Bollinger scoring method in evaluating peripheral artery angiography with 64-low computed tomography in patients with peripheral arterial disease.

AIM: There are various angiographic and runoff scoring systems for evaluating stenosis and arterial occlusion in patients with peripheral artery disease (PAD). The report from the BASIL trial revealed that the Bollinger scoring system, originally designed to classify intra-arterial digital subtraction angiography (IADSA), was sensitive to differences in PAD. The purpose of the present study was to evaluate the application of the Bollinger scoring system to a 64-low multidetector computed tomography (MDCT) in PAD patients.

METHODS: Patients with PAD who underwent both a 64-MDCT and DSA within a 4-year period were enrolled in the study. Two observers analyzed the MDCT and DSA images for each patient. We divided the arterial tree from the common iliac artery to the plantar arch into 16 segments and scored 0-15 points for each segment as reported by Bollinger, according to the severity and extent of disease. We analyzed the reliability of differences in scores between the DSA and MDCT by the intraclass correlation coefficients (ICCs).

RESULTS: We reviewed 100 consecutive patients (127 limbs) and assessed a total of 1929 segments. The Bollinger score of the 2 tests were same in 39.6% of all segments. The difference between the 2 tests were within 2 points in 77.3% of the above-knee segments (70.1-91.6% in each segments), 58.8% of the below-knee segments with the exception of plantar arch (42-74%). The ICC values showed relatively good reliability, but in the CFA the ICC values showed poor reliability.

CONCLUSION: The Bollinger scoring method is a useful tool to evaluate peripheral artery angiography with 64-low CT in patients with PAD.