I now have a comprehensive collection of lower limb angiogram images from multiple authoritative textbooks. Here is a complete, organized presentation:
Angiograms of the Lower Limbs
Below are all lower limb angiograms collected from authoritative surgical and radiology textbooks, organized by vascular territory from proximal to distal.
1. Arterial Anatomy of the Lower Limb (Reference Diagram)
Fig. 80.7A - Diagram of lower limb arterial anatomy showing the complete arterial tree from aorta to foot: Common iliac artery → External iliac artery → Common femoral artery → Superficial femoral artery (SFA) → Popliteal artery → Tibioperoneal trunk → Anterior tibial, Posterior tibial, and Peroneal arteries.
Source: Grainger & Allison's Diagnostic Radiology
2. Iliac Artery Region
2a. Embolisation of a Bleeding Lower Limb Artery (External Iliac / External Pudendal)
Fig. 80.6 - (A) Arterial phase axial CT shows active contrast extravasation within the pectineus muscle (post transvenous ablation). (B) Catheter angiogram via external iliac artery (contralateral femoral access) shows active bleeding from the external pudendal artery. (C) Super-selective catheterisation with microcatheter and embolisation using microcoils. (D) Post-embolisation angiogram confirms cessation of bleeding.
Source: Grainger & Allison's Diagnostic Radiology
2b. Iliac Angioplasty
Fig. 80.8 - (A) Flush angiogram from the distal aorta showing a tight stenosis at the right iliac bifurcation (arrow). (B) Improved lumen following 8-mm balloon angioplasty (POST PTA 8 x 40 mm balloon, arrow).
Source: Grainger & Allison's Diagnostic Radiology
2c. Iliac Artery Stenting
Fig. 80.9 - (A) Pelvic angiogram (RIGHT, LAO 22°) showing occlusion of the right common and external iliac artery with reconstitution distally via collateral vessels. (B) Post-procedure - Restored patency of the iliac artery following deployment of a bare metallic stent.
Source: Grainger & Allison's Diagnostic Radiology
3. Superficial Femoral Artery (SFA)
Subintimal SFA Angioplasty
Fig. 80.10 - Subintimal Superficial Femoral Artery Angioplasty: (A) Angiogram via sheath in the right common femoral artery shows moderate-length occlusion of the SFA. (B) The occlusion has been crossed subintimally with a hydrophilic guidewire. (C) Post-angioplasty angiogram (RIGHT, POST PTA) shows restored patency with good flow.
Source: Grainger & Allison's Diagnostic Radiology
4. Popliteal / Tibioperoneal Region
4a. Popliteal Artery Occlusion - Endovascular Treatment (6-stage sequence)
Fig. 61.19 - Six-stage angiographic sequence showing endovascular treatment of popliteal occlusion:
- (a) Occlusion of the popliteal artery extending into the tibioperoneal trunk (collateral vessels visible)
- (b) Lesion crossed with a catheter; angiogram confirming intraluminal positioning beyond the occlusion
- (c) Balloon angioplasty in progress
- (d) Angiogram demonstrating vessel recoil after initial PTA
- (e) Stents inserted to maintain the lumen; balloon being moulded
- (f) Completion angiogram showing restored patency
Source: Bailey and Love's Short Practice of Surgery, 28th Edition
5. Tibial (Crural) Vessels
Anterior Tibial Artery - Balloon Angioplasty
Fig. 91.5 - (A) Angiogram of the tibial arteries showing diffuse anterior tibial artery high-grade stenosis. (B) Long-segment balloon angioplasty catheter in place. (C) Completion angiogram showing patent anterior tibial artery with no significant residual stenosis.
Source: Mulholland and Greenfield's Surgery: Scientific Principles and Practice, 7th Edition
6. Bypass Grafts (Completion Angiograms)
Femoropopliteal and Femorodistal Bypass Grafts
Fig. 61.22 - (a) Completion angiogram of a femoropopliteal bypass graft (with a Miller cuff) - showing the graft running from the distal femur, across the knee joint, to the popliteal artery. (b) Completion angiogram of a femorodistal bypass graft in situ - showing the long saphenous vein graft extending to a distal tibial vessel.
Source: Bailey and Love's Short Practice of Surgery, 28th Edition
Summary Table
| Level | Vessels | Clinical Relevance |
|---|
| Aorto-iliac | Common/External iliac | Leriche syndrome, claudication |
| Femoral | CFA, SFA, Profunda | Most common site of atherosclerosis |
| Popliteal | Popliteal artery | Aneurysms, occlusive disease |
| Infrapopliteal (crural) | Anterior/Posterior tibial, Peroneal | Diabetic arteriopathy, critical limb ischaemia |
| Bypass grafts | Femoropopliteal, femorodistal | Limb salvage procedures |
Clinical note: Patients with peripheral arterial disease (PAD) and lifestyle-limiting claudication or critical limb ischaemia (rest pain or ischaemic tissue loss) are candidates for lower extremity angiogram and possible endovascular intervention. Endovascular-first approaches are preferred due to lower morbidity and repeatability, with surgical bypass reserved for failed endovascular therapy or complex anatomy. - Fischer's Mastery of Surgery, 8th Edition