CT SCAN ANGIOGRAPHY UPPER LIMBS (DELDC) at Dr. Essa Lab

CT SCAN ANGIOGRAPHY UPPER LIMBS (DELDC) at Dr. Essa Lab

A CT Scan Angiography Upper Limbs (DELDC) is a highly specialized, non-invasive diagnostic imaging procedure designed to evaluate the blood vessels of the arms, forearms, and hands. By combining the advanced technology of Multi-Detector Computed Tomography (MDCT) with the precise administration of intravenous iodinated contrast media, this examination provides high-resolution, three-dimensional visualization of the arterial and venous networks. At Dr. Essa Laboratory and Diagnostic Centre (DELDC), this procedure is performed using state-of-the-art CT scanners, ensuring exceptional spatial resolution and diagnostic accuracy for patients across Karachi and other major cities in Pakistan.

The primary objective of an upper limb CT angiography is to assess the patency, caliber, and course of the major blood vessels supplying the upper extremities. The examination begins at the level of the aortic arch or subclavian arteries and extends down to the digital arteries of the fingertips. This comprehensive coverage allows radiologists to identify vascular abnormalities such as stenoses, occlusions, aneurysms, vascular malformations, and traumatic injuries. The high-speed scanning capabilities of modern MDCT systems minimize motion artifacts, allowing for clear visualization of even the smallest arterial branches in the hand.

The clinical importance of this examination cannot be overstated. Vascular disorders of the upper limbs can lead to severe complications, including tissue ischemia, chronic pain, and limb-threatening gangrene. By providing detailed anatomical and pathological details, the CT Scan Angiography Upper Limbs (DELDC) serves as an invaluable tool for vascular surgeons, orthopedists, and emergency physicians. It assists in precise treatment planning, whether for endovascular interventions, surgical revascularization, or the management of acute trauma. The rapid acquisition of images and the non-invasive nature of the test make it a preferred alternative to traditional catheter-based digital subtraction angiography (DSA) in many clinical scenarios.

Clinical Procedure: What to Expect

Patient Preparation

Proper preparation is essential to ensure patient safety and obtain high-quality diagnostic images during a CT Scan Angiography Upper Limbs (DELDC). Patients are advised to adhere to the following guidelines:

• Fasting Requirements: Patients must fast for at least 4 to 6 hours prior to the procedure. This is a precautionary measure to minimize the risk of nausea or vomiting, which can occur as a reaction to the intravenous contrast medium.
• Kidney Function Test: Because the procedure requires the injection of iodinated contrast, patients must present a recent Serum Creatinine report (usually within the last 30 days). This is crucial to assess renal function and prevent Contrast-Induced Nephropathy (CIN).
• Hydration: Adequate hydration before and after the scan is highly recommended. Drinking plenty of water helps the kidneys flush out the contrast medium efficiently.
• Allergy History: Patients must inform the medical staff of any known allergies, especially to iodine, contrast media, shellfish, or specific medications. If a patient has a history of contrast allergy, a pre-medication protocol involving corticosteroids and antihistamines may be prescribed by their physician.
• Medication Instructions: Patients should discuss their current medications with the clinical staff. Diabetic patients taking Metformin may need to temporarily discontinue the medication for 48 hours after the scan, subject to their physician’s approval and post-procedure renal function.
• Clothing and Accessories: Patients should wear loose, comfortable clothing. All metallic objects, including jewelry, watches, zippers, and hairpins, must be removed from the upper body as they can cause significant artifacts on the CT images.

During the Procedure

The procedure is conducted in a specialized CT scan suite by certified radiologic technologists under the supervision of a consultant radiologist. The step-by-step process includes:

• IV Cannulation: A peripheral intravenous (IV) line is placed in a vein, typically in the arm contralateral to the one being investigated, to facilitate the rapid injection of the contrast agent.
• Patient Positioning: The patient lies supine on the motorized CT table. The arm being scanned is carefully positioned, often extended above the head or placed alongside the body, depending on the specific clinical indication and the scanner protocol. Immobilization devices may be used to help the patient remain perfectly still.
• Contrast Injection: An automated power injector is connected to the IV line. This device delivers a precise volume of iodinated contrast medium at a controlled flow rate. As the contrast enters the bloodstream, the patient may experience a transient warm sensation throughout the body or a metallic taste in the mouth, which are normal and temporary.
• Image Acquisition: The CT scanner utilizes advanced bolus tracking technology. This system monitors the arrival of the contrast medium in the target artery (such as the subclavian artery) and automatically triggers the scan at the moment of peak arterial opacification. The actual scanning process takes only a few seconds, during which the patient must remain absolutely still.
• Post-Procedure Care: Once the scan is complete, the IV line is removed, and a small dressing is applied. The patient is monitored for a short period to ensure there are no immediate adverse reactions to the contrast. Patients are encouraged to drink plenty of fluids for the remainder of the day.

When is a CT SCAN ANGIOGRAPHY UPPER LIMBS (DELDC) Performed?

Evaluation of Upper Extremity Peripheral Arterial Disease (PAD)

While peripheral arterial disease is more common in the lower limbs, it can also affect the upper extremities. Physicians request a CT Scan Angiography Upper Limbs (DELDC) when patients present with symptoms of upper limb ischemia, such as arm claudication (pain during activity), cold sensitivity, or digital ulcers. The scan helps identify the precise location, length, and severity of arterial stenoses or occlusions, allowing vascular specialists to determine whether endovascular balloon angioplasty, stenting, or surgical bypass grafting is required.

Assessment of Acute Vascular Trauma or Injury

In cases of penetrating or blunt trauma to the upper limbs—such as gunshot wounds, deep lacerations, or complex bone fractures—the adjacent blood vessels are at high risk of injury. A CT angiography is rapidly performed in emergency settings to detect active arterial extravasation, pseudoaneurysms, arterial dissections, or complete vessel transection. The rapid and precise localization of vascular damage is critical for planning immediate surgical intervention to salvage the limb and prevent life-threatening hemorrhage.

Diagnosis of Thoracic Outlet Syndrome (TOS)

Thoracic Outlet Syndrome occurs when the blood vessels or nerves in the space between the collarbone and the first rib (thoracic outlet) become compressed. When vascular TOS is suspected, a CT Scan Angiography Upper Limbs (DELDC) may be performed with the patient’s arm in both neutral and hyperabducted positions. This dynamic imaging approach allows radiologists to visualize positional compression of the subclavian artery or vein, helping to confirm the diagnosis and guide surgical decompression strategies.

Investigation of Vasculitis and Inflammatory Arterial Diseases

Inflammatory conditions of the blood vessels, such as Buerger’s disease (thromboangiitis obliterans), Takayasu arteritis, or Giant Cell Arteritis, can severely compromise blood flow to the upper limbs. Patients often present with symptoms like Raynaud’s phenomenon, asymmetric pulses, or unexplained upper extremity pain. The high-resolution imaging provided by CT angiography allows for the evaluation of characteristic vessel wall thickening, long-segment narrowing, and collateral vessel formation associated with these inflammatory conditions.

Pre-operative Planning for Reconstructive or Bypass Surgery

Before performing complex reconstructive surgeries, such as free tissue transfers or coronary artery bypass grafting (CABG) utilizing the radial artery, surgeons must ensure the patency and adequacy of the donor vasculature. A CT Scan Angiography Upper Limbs (DELDC) is utilized to map the arterial anatomy of the forearm and hand, verifying that the ulnar artery provides sufficient collateral flow to the hand (a radiological equivalent of the Allen’s test) before the radial artery is harvested.

What Does a CT SCAN ANGIOGRAPHY UPPER LIMBS (DELDC) Detect?

A CT Scan Angiography Upper Limbs (DELDC) is highly sensitive and specific, capable of detecting a wide range of vascular and perivascular pathologies, including:

• Atherosclerotic plaque accumulation and calcification
• Arterial stenosis (narrowing of the vessel lumen)
• Complete arterial occlusion (blockage)
• True arterial aneurysms (abnormal dilation of the vessel wall)
• Pseudoaneurysms (false aneurysms resulting from vessel wall injury)
• Arteriovenous malformations (AVMs) and fistulas (AVFs)
• Acute arterial thrombosis or embolism
• Arterial dissection (tearing of the inner layer of the arterial wall)
• Thoracic outlet compression of the subclavian vessels
• Vasculitis-induced vessel wall thickening and luminal narrowing
• Buerger’s disease (thromboangiitis obliterans) pathology
• Raynaud’s phenomenon-associated vasospasm
• Vascular compression by cervical ribs or fibrous bands
• Active contrast extravasation indicating acute hemorrhage
• Traumatic vessel transection or laceration
• Anatomical variants of the upper limb vasculature (e.g., high origin of radial artery)
• Post-surgical graft patency, stenosis, or occlusion
• Intravascular stent patency or in-stent restenosis
• Collateral pathway development in chronic ischemia
• Extrinsic vascular compression by soft tissue masses or tumors
• Fibromuscular dysplasia (FMD) of the upper limb arteries
• Subclavian steal syndrome (retrograde flow in the vertebral artery)
• Venous thrombosis (e.g., Paget-Schroetter syndrome)
• Soft tissue hematomas compressing adjacent neurovascular bundles

Turnaround Time and Report Access at Dr. Essa Lab

At Dr. Essa Laboratory and Diagnostic Centre, we understand that timely results are critical for effective clinical decision-making. Once the CT Scan Angiography Upper Limbs (DELDC) is completed, the raw imaging data is processed using advanced 3D reconstruction software to generate detailed angiographic views. These images are meticulously reviewed by a qualified consultant radiologist specializing in cardiovascular and peripheral vascular imaging.

The finalized diagnostic report, along with high-resolution printed films or digital media, is typically available within 24 to 48 hours after the procedure. In urgent or emergency cases, preliminary findings can be communicated directly to the referring physician immediately after the scan. Dr. Essa Lab offers convenient digital report access through its official online portal and mobile application, allowing patients and their healthcare providers to view and download reports and images from the comfort of their homes.

CT SCAN ANGIOGRAPHY UPPER LIMBS (DELDC) Findings Overview

The following table provides an overview of the anatomical structures evaluated during a CT Scan Angiography Upper Limbs (DELDC), along with typical normal and abnormal findings:

Structure / Parameter Evaluated	Normal Findings	Possible Abnormal Findings
Subclavian Artery	Smooth contours, uniform caliber, no luminal narrowing or extrinsic compression.	Stenosis, occlusion, plaque calcification, compression at the thoracic outlet, aneurysm.
Axillary Artery	Patent lumen, normal course through the axilla, no filling defects.	Traumatic laceration, thrombosis, pseudoaneurysm, compression by axillary masses.
Brachial Artery	Continuous contrast opacification, normal bifurcation at the cubital fossa.	Embolic occlusion, dissection, spasm, traumatic injury associated with humerus fractures.
Radial and Ulnar Arteries	Symmetrical caliber, bilateral patency, smooth flow down to the wrist.	Severe stenosis, occlusion due to Buerger’s disease, atherosclerotic narrowing, vasospasm.
Palmar Arches (Superficial & Deep)	Complete, well-opacified arches with intact flow to digital arteries.	Incomplete arches, occlusion of digital branches, microemboli, vasculitic changes.
Venous Drainage System	Normal contrast enhancement of deep and superficial veins (if venous phase is acquired).	Deep vein thrombosis (DVT), superficial thrombophlebitis, venous stenosis, compression.
Surrounding Soft Tissues	Normal tissue planes, no abnormal fluid collections, masses, or bone fragments.	Hematoma, abscess, soft tissue tumors compressing vessels, displaced bone fractures.

Note: Diagnostic findings should always be interpreted by a qualified healthcare professional together with the patient’s symptoms, medical history, physical examination, laboratory investigations, previous imaging studies, and other relevant clinical information. Additional investigations or specialist consultation may be recommended depending on the findings.

Why Choose Dr. Essa Lab for CT SCAN ANGIOGRAPHY UPPER LIMBS (DELDC)?

• Experienced Healthcare Professionals: Our team consists of highly qualified consultant radiologists and certified technologists specializing in advanced vascular imaging.
• Patient-Focused Care: We prioritize patient comfort, safety, and clear communication throughout the entire diagnostic process.
• Quality Diagnostic Services: Dr. Essa Lab is committed to delivering highly accurate, reproducible, and clinically valuable diagnostic reports.
• Modern Diagnostic Approach: We utilize state-of-the-art multi-detector CT scanners capable of high-speed scanning and advanced 3D vascular reconstructions.
• Convenient Location: With an extensive network of branches across Karachi and other cities, patients can easily access our diagnostic services.
• Professional Reporting: Our detailed reports provide comprehensive anatomical and pathological insights to assist referring physicians in treatment planning.
• Comfortable Environment: Our imaging suites are designed to provide a calm, reassuring, and hygienic environment for all patients.
• Commitment to Accurate Diagnosis: Since 1987, Dr. Essa Lab has maintained a legacy of trust, quality, and excellence in the healthcare sector of Pakistan.