CT Peripheral Angiography in Delhi 2026

A CT peripheral angiogram is the study that turns “there is a blockage somewhere in the leg” into an exact map a surgeon can act on. It traces every artery from the abdominal aorta, through the pelvis and thigh, down past the knee, to the small vessels of the calf and the arch of the foot.

It is ordered when the question has moved from whether there is arterial disease to where it is, how long it is, and what is still open beyond it — because those three facts decide whether an angioplasty is possible, whether a bypass is possible, and where a bypass could be attached.

Before anything else, one urgent exception.

If a leg has suddenly become cold, pale, numb and pulseless, this is not a scan appointment

Acute limb ischaemia — a leg that becomes suddenly painful, cold, pale or mottled, numb, weak and without a pulse — is a surgical emergency. Muscle and nerve begin to die within hours, and the window for saving the limb is measured in hours, not days.

The correct action is an emergency department or a vascular surgeon immediately. Any imaging needed will be arranged there, at emergency speed, often alongside treatment. Booking an outpatient CT angiogram for next week in that situation can cost the leg.

The rest of this page is about the planned investigation of chronic arterial disease, which is an entirely different clinical situation and the reason the great majority of these scans are done.

What a CT peripheral angiogram actually is

It is a CT scan of the arteries of the limbs, taken while iodinated contrast is flowing through them. For the legs — by far the commonest request — the coverage runs from the abdominal aorta down to the feet, usually written as a CT peripheral angiogram, CT angiography lower limbs, CTA peripheral, or CT aortogram with run-off.

The scanner acquires a continuous set of very thin slices, and the computer then reconstructs the data in several ways: the standard axial images, plus maximum intensity projections that look like a conventional angiogram, three-dimensional renderings, and curved reformats that straighten out a winding artery so its entire length can be inspected in one picture.

Without contrast none of this is possible — an artery and the muscle around it have almost identical density on a plain CT. The injection is what makes the vessel lumen visible, and it is why the preparation below matters.

Our general CT guide covers the technology, and the same timing principle applies in the brain and the coronary arteries.

Why your doctor has ordered it

Intermittent claudication — cramping calf, thigh or buttock pain that comes on after a predictable walking distance and goes away with rest. The classic symptom of peripheral arterial disease.
Rest pain — pain in the foot at rest, classically worse lying flat at night and relieved by hanging the leg down. A warning sign that the circulation is critically reduced.
A non-healing ulcer or gangrene — together with rest pain, this is chronic limb-threatening ischaemia, and it needs mapping urgently rather than routinely.
Before an angioplasty, stent or bypass — this is the single biggest reason. The scan is the operative roadmap.
Diabetic peripheral arterial disease — which behaves differently from ordinary atherosclerosis, as explained below.
Aneurysm of the popliteal or femoral artery, or a pseudoaneurysm after a puncture or injury.
Trauma with suspected arterial injury.
Suspected embolism, and identifying where it came from.
Buerger’s disease (thromboangiitis obliterans) — a distinct inflammatory arterial disease affecting young, usually male, heavy smokers, with characteristic distal involvement and corkscrew collaterals. Clinically important in India.
Popliteal artery entrapment — a cause of calf claudication in young athletes, where the artery is compressed by surrounding muscle rather than diseased.
Vascular malformations.
Surveillance of a previous graft or stent, where a Doppler has raised a question.

Run-off vessels: the single most important thing in your report

If you read one section, read this. It explains why the report talks about the calf so much.

Below the knee, the leg is supplied by three arteries: the anterior tibial, the posterior tibial, and the peroneal (fibular). These are the run-off vessels. They carry blood into the foot, where the posterior tibial and anterior tibial normally join to form the pedal arch.

Here is why a surgeon cares so much. A bypass graft or an angioplasty has to deliver blood into something. If all three calf vessels are blocked right down to the ankle, there is no target to deliver blood to — and reopening the artery in the thigh achieves very little. If even one calf vessel is patent down to the foot with an intact pedal arch, there is a target, and limb salvage becomes realistic.

So your report will say things like “single-vessel run-off via the peroneal artery with an incomplete pedal arch”. That sentence is not jargon for its own sake. It is the sentence that decides whether a leg can be revascularised, and how.

Reports may also reference formal classification systems used by vascular surgeons to grade the pattern and severity of disease by anatomical segment. Which system is used, and what it implies for treatment, is a matter for your vascular surgeon.

Diabetic and kidney-disease arteries: the honest limitation of this scan

This section matters enormously in Delhi, and most pages about CT angiography skip it.

Atherosclerosis in a non-diabetic typically affects the larger, more proximal arteries — the aortoiliac segment and the femoral artery. Those are big vessels, and CT images them beautifully.

Diabetic arterial disease is different. It characteristically affects the tibial and peroneal arteries below the knee — small vessels, often long segments, frequently sparing the foot vessels themselves. And critically, in diabetes and in chronic kidney disease these small arteries often develop dense, circumferential calcification in their walls.

That calcification is a genuine technical problem for CT. Calcium is extremely bright on CT, and in a vessel only two or three millimetres across the bright wall can bloom inwards and obscure the lumen entirely. The radiologist may then be unable to say whether the artery is narrowed, blocked, or actually open inside a heavily calcified wall.

A careful report will say so — for example “dense circumferential calcification of the tibial arteries limits assessment of the lumen”. That is not a poor-quality scan. It is an honest limitation being declared, and it is far more useful to a surgeon than a confident guess.

When this happens, the alternatives your doctor may turn to include:

MR angiography, where calcium produces no signal at all and therefore does not obscure the lumen. This is a real advantage in heavily calcified vessels, though MRA has its own limitations around stents and motion.
Catheter angiography (DSA), which remains the reference standard and is usually performed at the time of intervention anyway.
Dual-energy CT techniques, where available, which can help separate calcium from contrast.

If the problem has already progressed to the foot itself, our page on the MRI ankle and foot covers the separate and equally important question in a diabetic foot — whether infection has reached the bone, and whether what is happening is osteomyelitis or Charcot neuroarthropathy.

Contrast timing: why this scan is technically demanding

A peripheral CT angiogram is one of the harder CT studies to get right, and understanding why helps you understand the report.

The scanner has to follow the contrast as it travels down the legs. Acquire too early and the calf and foot vessels have not filled yet — they will look blocked when they are not. Acquire too late and the veins have filled as well, and venous contrast superimposed on the arteries makes the images difficult to read.

The acquisition is therefore triggered by bolus tracking — the scanner watches the aorta and starts when the contrast reaches a set threshold — and then moves down the table at a speed matched to the expected flow.

The complication is that in severe arterial disease the flow is slow and asymmetric. A leg with a long femoral occlusion fills through collaterals, far later than a healthy leg. A standard timing will miss its calf vessels. A good centre anticipates this and adds a delayed acquisition of the lower legs when the clinical history suggests severe disease.

Which is why one piece of practical advice matters: make sure the clinical history is written on your prescription, or tell the centre yourself. “Rest pain and a non-healing ulcer on the left great toe, diabetic for eighteen years” produces a different and better protocol than “lower limb CT angiography”.

Preparation

Kidney function test. A recent serum creatinine with eGFR is usually required, because iodinated contrast is cleared by the kidneys. This matters especially here, because the patient group — diabetic, hypertensive, often with established kidney disease — is precisely the group at higher risk. Get this organised in advance; our health checkup page explains the renal panel.
Fasting for about four to six hours of solid food, mainly to reduce nausea and to make management safer should a reaction occur. Plain water is generally allowed — and staying well hydrated beforehand is usually encouraged unless your doctor has restricted fluids.
Metformin. Tell the centre and your doctor. Current guidance does not require stopping metformin before intravenous contrast when kidney function is reasonably preserved, but the advice differs when eGFR is low or you are acutely unwell. This decision belongs to your treating doctor. Bring the name and dose of everything you take.
Allergy history. Declare any previous reaction to contrast or iodine, and any asthma. A documented previous contrast reaction changes the plan.
Other medicines. Bring your full list, including blood thinners and antiplatelets — not because they affect the scan, but because they affect what happens next.
Thyroid disease. Mention active hyperthyroidism, and any planned radioiodine scan or treatment, which iodinated contrast can interfere with for some weeks.
Previous imaging. Bring earlier Dopplers, CT or MR angiograms, and any operative or angioplasty notes. Knowing where a stent or graft already sits changes how the images are read.
Remove metal from the lower body, and wear clothing without metal fastenings.
Bring someone with you if walking is painful or limited.

What happens during the scan

Check-in and screening — prescription, kidney function, allergies, diabetes medication, pregnancy.
Cannula. A reasonably large-bore intravenous cannula, usually 18 or 20 gauge, in the arm. A thin cannula cannot take the injection rate this study needs.
Positioning. You lie on your back, feet first, with the legs straight and lightly strapped together so they cannot roll or move. Keeping them still is important — movement during a long acquisition blurs the small calf vessels.
Scout images to plan coverage from the aorta to the toes.
Contrast injection by pump, with bolus tracking over the aorta.
The acquisition, as the table moves down following the contrast. A warm flush spreading through the body and a metallic taste are expected and pass within about half a minute.
Delayed lower-leg acquisition if the flow is slow or the first pass has not filled the calf vessels.
Reconstruction into axial, MIP, 3D and curved reformat images.
Cannula removal and a short observation period.

Expect roughly 30 to 45 minutes in total, of which the scanning itself is less than a minute.

Risks, stated plainly

This is a well-established study, but it is a contrast study with meaningful radiation, and you deserve both stated.

Contrast reactions

Mild reactions such as hives, itching or nausea occur in a small minority and usually need only observation or an antihistamine. Moderate reactions needing treatment are less common, and severe reactions are rare. Centres that give contrast keep emergency drugs and resuscitation equipment ready because rare events still have to be planned for. A previous reaction is the strongest predictor of another.

Effect on the kidneys

Contrast can occasionally cause a transient rise in creatinine. The risk is clinically meaningful mainly in significantly reduced kidney function, dehydration, diabetes with kidney involvement and heart failure — which overlaps heavily with the population having this scan. This is exactly why kidney function is checked first, why hydration is encouraged, and why your doctor may choose MR angiography or go straight to catheter angiography instead in some cases.

Radiation

Coverage from the abdomen to the feet is long, and adding a delayed lower-leg series increases the dose further. A peripheral CT angiogram therefore involves a meaningfully higher dose than most single-region CT studies. Modern dose-reduction techniques help considerably, but the honest position is that this is a higher-dose examination and it should be done when it will change management — which, before a planned revascularisation, it almost always does.

Extravasation

Rarely, contrast leaks into the tissues of the arm rather than the vein, causing swelling and pain at the site. Telling the technologist the moment your arm hurts during the injection is the best protection.

CT angiography versus arterial Doppler versus MR angiography versus DSA

These four are not competing; they sit in sequence.

Arterial Doppler ultrasound is the first-line test. No radiation, no injection, inexpensive, repeatable. It measures the ankle-brachial index and segmental pressures and velocities, which together establish whether significant arterial disease is present and roughly at what level. For most patients with claudication, a Doppler plus clinical assessment is genuinely sufficient — and if the plan is exercise therapy, smoking cessation and medical management rather than intervention, no CT is needed at all. Our arterial Doppler page covers it in full. Its limitations are operator dependence, difficulty with the aortoiliac segment in larger patients, and the fact that it does not produce a surgical map.

CT angiography is the mapping test. You order it when intervention is on the table and you need to know exact segment lengths, occlusion extent, collaterals and run-off. Fast, widely available, excellent spatial detail. Limited by calcification, radiation and contrast.

MR angiography uses no ionising radiation and — importantly here — is not defeated by calcification. It is a strong alternative in heavily calcified diabetic or renal patients, and in those who cannot have iodinated contrast. It is slower, more motion-sensitive, less good around metal stents, and uses gadolinium, which has its own precautions. See our contrast MRI page.

Catheter angiography (DSA) remains the reference standard and the most precise, but it is invasive and carries a small procedural risk. In practice it is increasingly performed at the moment of treatment rather than as a separate diagnostic step — the angioplasty and the angiogram happen in one sitting.

The short version: Doppler to find out whether there is significant disease and where. CT or MR angiography to map it when intervention is planned. DSA when treating.

One related distinction worth making: if the leg is swollen rather than pale and painful on walking, the question is likely venous rather than arterial, and the tests are a venous Doppler or CT venography, not an arterial study.

Reading your report: a plain-English glossary

Stenosis — narrowing, usually given as a percentage or as mild, moderate, severe or critical.
Occlusion — complete blockage. The report should give its length, which strongly influences whether angioplasty is feasible.
Short-segment versus long-segment disease — short occlusions are generally more amenable to angioplasty; long ones more often need a bypass.
Collaterals — alternative routes the body has grown around a blockage. Good collaterals explain why someone with a complete occlusion can still walk a reasonable distance.
Run-off — how many of the three calf arteries remain patent, and how far down. “Three-vessel run-off” is the best case; “no run-off” is the worst.
Pedal arch — the connection in the foot between the tibial arteries. An intact arch matters for limb salvage.
Reconstitution — an artery that is blocked and then becomes patent again further down, usually refilled by collaterals. A reconstituted segment can serve as a bypass target.
Aortoiliac / femoropopliteal / infrapopliteal (tibial) — the three anatomical levels disease is described at. Diabetic disease is typically infrapopliteal.
Circumferential calcification — calcium right around the vessel wall. The main cause of limited assessment, as described above.
Eccentric plaque — plaque on one side of the vessel only.
In-stent restenosis — renarrowing inside a previously placed stent.
Graft occlusion — a previous bypass that has blocked.
Corkscrew collaterals — a characteristic appearance described in Buerger’s disease.
Beading — alternating narrowing and widening, which can suggest an inflammatory or dysplastic process rather than atherosclerosis.
Aneurysm / ectasia — abnormal widening of an artery.
Venous contamination — veins filled with contrast overlapping the arteries. A technical limitation, usually from slow flow.

One caution: the degree of narrowing on a scan does not map neatly onto how far you can walk. Two people with identical images can have very different symptoms, depending on collaterals, fitness and other conditions. This is exactly why the decision to intervene is made on symptoms and function, with the scan as the map — not the other way round. Take the report to the doctor who ordered it.

What the scan cannot do

It does not treat anything. It is a map. The treatment — angioplasty, stenting, bypass or medical management — is separate.
It does not measure function. Ankle-brachial index, walking distance and segmental pressures come from a Doppler and from clinical assessment.
It is defeated by dense calcification in small vessels, as described above.
It is not the emergency test for a suddenly ischaemic leg — that is a surgical emergency handled in hospital.
It cannot replace a tissue diagnosis or a culture where infection is the problem.
It does not fix the cause. Worth saying plainly: in atherosclerotic disease, stopping smoking, controlling diabetes, blood pressure and cholesterol, and supervised walking exercise do more for long-term limb and life outcomes than any single procedure. A good scan and a good angioplasty do not substitute for those.

After the scan

Drink water generously for the rest of the day unless your doctor has restricted your fluids.
Resume food and activity immediately; there are no restrictions after a routine contrast CT.
Watch the cannula site for increasing swelling, pain or redness, and report it.
Delayed reactions — a rash appearing hours to a couple of days later — are uncommon but should be reported and recorded, because it matters for any future contrast study.
Collect a digital copy of the images. This is not optional for this study. A vascular surgeon or interventional radiologist needs to scroll the dataset and rotate the reconstructions; a printed report alone is not enough to plan an intervention from.
Keep it. It becomes the baseline for every later comparison, including after any procedure.

What a CT peripheral angiogram costs in Delhi

The price depends on real variables: whether one limb or both are covered, whether the aortoiliac segment is included, whether a delayed lower-leg acquisition is needed, the contrast volume used, whether full three-dimensional and curved reformats and a radiologist’s report are included, whether a kidney function test has to be done on site first, and whether you need it urgently or outside normal hours.

Because of that we do not publish a fixed figure here that could be out of date by the time you read it, or that might not match what your prescription asks for. The fastest way to get an accurate, all-inclusive number is to send us a photo of your prescription on WhatsApp. You will get today’s actual price for exactly the study your doctor has specified — including the report and the reconstructions — along with what to bring and the next available slot, before you travel.

Send your prescription on WhatsApp for today’s CT peripheral angiography price → | Call 9555999960

For a wider view of CT pricing see our CT scan cost in Delhi page.

Getting a CT peripheral angiogram in West Delhi

At Edge Imaging & Diagnostics, a NABH-accredited diagnostic centre in Paschim Vihar, West Delhi, a CT peripheral angiogram is performed with bolus-tracked acquisition, a delayed lower-leg series added where the clinical history indicates slow flow, and full multiplanar, MIP and three-dimensional reconstructions reported by a radiologist.

Practical points worth knowing:

Tell us the clinical history. “Rest pain with a non-healing toe ulcer in a long-standing diabetic” changes the protocol — a delayed calf acquisition is planned from the outset rather than discovered to be necessary afterwards. This is the single most useful thing you can do for the quality of your own scan.
Kidney function on site. Pathology is in the same building, so arriving without a recent creatinine does not have to mean rescheduling.
Doppler first if that is what you actually need. If your doctor has not yet decided on intervention, an arterial Doppler may be the appropriate study — no radiation, no contrast, and often enough. We will say so rather than simply performing the more expensive test.
Everything under one roof — CT, MRI, ultrasound and Doppler, digital X-ray and pathology in the same building, which matters when a diabetic foot needs an arterial study, an MRI of the foot for possible osteomyelitis, and blood tests, all in one visit.
Bring previous Dopplers, angiograms and operative notes.
Open on Sunday — see our Sunday diagnostic centre page.
CGHS and DGHS empanelled — details on our empanelment page.
Where patients travel from — Paschim Vihar, Rajouri Garden, Tagore Garden, Punjabi Bagh, Janakpuri, Tilak Nagar, Vikas Puri, Moti Nagar, Nangloi and Raghubir Nagar. See our West Delhi diagnostic centre and Rajouri Garden pages.
Related vascular studies — carotid Doppler, renal Doppler and interventional radiology.

Frequently asked questions

Is a CT peripheral angiogram painful?

The only painful part is the cannula going into the vein in your arm, which feels like an ordinary blood test. The scan itself is painless. During the injection most people feel a warm flush spreading through the body and a metallic taste, both of which pass within about half a minute.

How long does the appointment take?

The scanning itself takes under a minute. Allow roughly 30 to 45 minutes in total for the cannula, the injection, the acquisition, any delayed series, a short observation period and the image check. Longer if a kidney function test has to be done first.

Do I need to fast?

Usually yes — about four to six hours without solid food, mainly to reduce nausea and make things safer should a reaction occur. Plain water is generally permitted, and staying well hydrated beforehand is usually encouraged unless your doctor has restricted fluids. Confirm with the centre when you book.

Why do I need a kidney function test first?

Because iodinated contrast is cleared by the kidneys. This matters particularly for this scan, since the patients having it are often diabetic, hypertensive and may already have kidney disease. A recent serum creatinine with eGFR lets your doctor decide whether to proceed, adjust the protocol, or choose MR angiography instead.

I take metformin. Should I stop it?

Tell the centre and your doctor, and let your doctor decide. Current guidance does not require stopping metformin before intravenous contrast when kidney function is reasonably preserved, but the advice differs when kidney function is low or you are acutely unwell. Bring the name and dose of your medication.

What are run-off vessels and why does my report keep mentioning them?

Below the knee the leg is supplied by three arteries — anterior tibial, posterior tibial and peroneal. These are the run-off vessels, and they carry blood into the foot. They matter because any angioplasty or bypass must deliver blood into something. If all three are blocked to the ankle there is no target and revascularisation achieves little; if even one is patent to the foot with an intact pedal arch, limb salvage becomes realistic. That is why the report describes them in detail.

My report says calcification limits assessment. Is that a bad scan?

No — it is an honest limitation being declared, and it is more useful than a confident guess. Dense circumferential calcification is very common in diabetes and chronic kidney disease, and in a vessel two or three millimetres wide the bright calcium can obscure the lumen entirely. When this happens your doctor may turn to MR angiography, which is not affected by calcium, or to catheter angiography.

Why is diabetic arterial disease different?

It characteristically affects the small tibial and peroneal arteries below the knee rather than the larger arteries in the pelvis and thigh, often over long segments, and it is frequently accompanied by dense wall calcification. That combination makes it both harder to image on CT and harder to treat — which is why the run-off and pedal arch findings carry so much weight in these patients.

Do I really need a CT, or is a Doppler enough?

Often a Doppler is enough. An arterial Doppler with an ankle-brachial index establishes whether significant disease is present and roughly at what level, with no radiation and no injection. If your doctor is planning exercise therapy, smoking cessation and medical management rather than an intervention, a CT angiogram usually adds nothing. The CT becomes necessary when intervention is being planned and an exact anatomical map is required.

What is the radiation dose?

Higher than most single-region CT studies, because the coverage runs from the abdomen to the feet and a delayed lower-leg series is often added. Dose-reduction techniques help considerably, but this is honestly a higher-dose examination. It is justified when it will change management, which before a planned revascularisation it almost always does.

Can I have it if I am allergic to contrast dye?

Declare the reaction in detail before anything else — what happened and how it was treated. Depending on severity, your doctor may arrange premedication, or choose MR angiography or catheter angiography instead. A previous reaction is the strongest predictor of another, so this is not a detail to leave out.

My leg suddenly went cold, pale and numb. Should I book this scan?

No. That is acute limb ischaemia and it is a surgical emergency — muscle and nerve begin to die within hours. Go to an emergency department or contact a vascular surgeon immediately. Any imaging needed will be arranged there at emergency speed, often alongside treatment.

What is the difference between CT angiography and a catheter angiogram?

CT angiography injects contrast into a vein in your arm and images the arteries non-invasively. A catheter angiogram (DSA) threads a catheter directly into the arteries and injects contrast there — more precise, and still the reference standard, but invasive with a small procedural risk. In practice DSA is increasingly done at the same time as the treatment itself rather than as a separate diagnostic step.

Will the scan tell me whether I need surgery?

It gives the anatomical information that decision rests on — where the disease is, how long each occlusion is, what collaterals exist and what run-off remains. But the decision to intervene is made on your symptoms and function, not on the images alone. Two people with near-identical scans can have very different walking distances. Your vascular surgeon puts the two together.

My report mentions corkscrew collaterals. What does that suggest?

That appearance is described in Buerger’s disease (thromboangiitis obliterans), an inflammatory arterial condition seen in young, usually male, heavy smokers, affecting the distal vessels. It is a pattern rather than a proof, and the diagnosis is clinical as well as radiological. If it is raised, stopping smoking completely is the single most important intervention — discuss it with your doctor.

Can both legs be done together?

Yes, and they usually are, because the coverage naturally includes both and comparison between sides is informative. Confirm what your prescription specifies when you book, since it affects the price.

Should I have follow-up scans at the same centre?

Where practical, yes. After an angioplasty, a stent or a bypass, the question is usually whether anything has changed, and that comparison is most reliable when the protocol, timing and reconstruction technique are consistent and the reporting radiologist has the previous dataset in front of them.

How soon will I get the report?

Ask when you book. At Edge Imaging & Diagnostics a routine report is normally available the same day, with urgent studies — including limb-threatening ischaemia — reported faster. Make sure you collect a digital copy of the images, not just the printed report, because an intervention cannot be planned from a printout.

Medically reviewed by Dr. Nishant Thapar, Consultant Radiologist and Founder, Edge Imaging & Diagnostics, West Delhi. Last reviewed: October 2026.

Disclaimer: This article is general patient information and does not replace a consultation. Imaging findings must always be interpreted together with your symptoms, examination, ankle-brachial index and other tests by the doctor treating you. All decisions about angioplasty, stenting, bypass surgery, amputation or medical management belong to your treating vascular surgeon or interventional radiologist. Contrast administration, fasting, hydration and metformin decisions must be made by your treating doctor for your individual situation. Do not start, stop or change any treatment on the basis of this page. A leg that has suddenly become cold, pale, numb, weak or pulseless is a surgical emergency — attend an emergency department immediately rather than booking an outpatient scan.