Multi-phase postmortem CT angiography (MPMCTA): a new axillary approach suitable in fatal thromboembolism

Postmortem computed tomography is widely used in the forensic pathology setting as supplementing medico-legal investigations and being capable of providing significant data that affect final conclusions and adding new quality to recording postmortem observations. The integration with angiographic methods [postmortem computed tomography angiography and multiphase postmortem CT angiography (MPMCTA)] allows the examination of the cardiovascular system and it is increasingly being utilised in the field of forensic pathology. However, using the standardised procedure that establishes the femoral vessels on one side of the corpse as an access point to the vascular system, visualisation of the vascular tree below the cannula insertion site is excluded. Consequently, visualisation of the vascular anatomy and morphology of the lower limbs is impossible and lesions such as thrombosis of the superficial and deep venous system may remain elusive. Bearing in mind the high incidence of pulmonary thromboembolism in forensic case studies and the difficulties in postmortem diagnosis, we propose a new axillary approach for MPMCTA that allows the full detection of the vascular system of the lower limbs.