Background: Acute Kidney injury is recognised to occur after administration of iodinated contrast
during endovascular interventions for peripheral arterial disease. There are no standardised protocols for contrast
delivery during infrainguinal angiography.
Objective: The objective of this paper is to review published practice regarding the technique of conventional
infrainguinal angiography and intervention, and describe a standard set of subtraction views, injection rates and
contrast volumes for infrainguinal angioplasty.
Methods: Database searches and review of papers containing (Angioplasty or Angiography) and (“lower limb” or
peripheral or infrainguinal) and (method or technique or guidelines or protocol) was performed and defined procedures
Results: A small number of papers provided specific technical details relating to contrast volumes and angiography
views. There was considerable variation from authors who have described the contrast volumes used for
lower limb angiography. We describe our simple and consistent method. The precise pathophysiology of contrast
related nephropathy is under scrutiny. There is interest in new technology to minimise contrast induced kidney
Conclusion: Few publications specify iodinated contrast doses, injection volumes or imaging views for infrainguinal
arteriography. Standard infrainguinal angioplasty can be performed with conventional equipment using
relatively small volumes of contrast by following a systematic technique.