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> Procedures > Diagnostic Procedure > Angiography, Digital Subtraction

Angiography, Digital Subtraction

Angiography, Digital Subtraction is a radiographic technique that enhances the visualization of blood vessels and other structures by electronically subtracting the image of the body part before the injection of a radiopaque contrast medium.
This process allows for the clear depiction of the blood vessels, making it a valuable tool in the diagnosis and treatment of various cardiovascular and vascular conditions.
The latest advancements in this field have led to improved image quality, reduced radiation exposure, and enhanced diagnostic capabilities.
Researches in this area continue to explore new techniques and technologies to furthr optimize the usefulness of digital subtraction angiography in clinical practice.

Most cited protocols related to «Angiography, Digital Subtraction»

1
MR CLEAN Registry Endovascular Stroke Therapy
Enrolment in the MR CLEAN Registry started directly after the final randomisation in the MR CLEAN trial on 16 March 2014. From 16 March 2014 to 31 December 2014 this was done retrospectively. From January 2015 onwards, enrolment was prospective. Sixteen centres participated in the MR CLEAN trial and are considered “MR CLEAN centres.” Two non-MR CLEAN centres started performing endovascular treatment later on and added patients to the MR CLEAN Registry, but these patients are not included in this analysis. The study data for patients undergoing endovascular treatment up to 15 June 2016 in the 16 MR CLEAN centres were completed and analysed and are reported here.
All patients undergoing endovascular treatment (defined as entry into the angiography suite and receiving arterial puncture) for acute ischaemic stroke in the anterior and posterior circulation have been registered in the MR CLEAN Registry. To adequately compare results with the MR CLEAN trial, in the current analysis we included those patients who adhered to the following criteria: arterial puncture within 6.5 hours of symptom onset, age 18 years and older, treatment in a centre that participated in the MR CLEAN trial, and proximal intracranial vessel occlusion in the anterior circulation (internal carotid artery (ICA), internal carotid artery terminus (ICA-T), middle (M1/M2) cerebral artery, or anterior (A1/A2) cerebral artery), shown by computed tomography angiography, magnetic resonance angiography, or digital subtraction angiography. No upper age limit, minimum Alberta Stroke Program Early Computed Tomography Score (ASPECTS), or collateral grade were imposed on treating doctors, nor was an extracranial occlusion by atherosclerosis or dissection an exclusion criterion.
Jansen I.G., Mulder M.J, & Goldhoorn R.J. (2018). Endovascular treatment for acute ischaemic stroke in routine clinical practice: prospective, observational cohort study (MR CLEAN Registry). The BMJ, 360, k949.
Publication 2018
Acute Ischemic Stroke Angiography Angiography, Digital Subtraction Angle Class III Arteries Atherosclerosis Blood Vessel Cerebral Arteries Cerebrovascular Accident Computed Tomography Angiography Dental Occlusion Dissection Internal Carotid Arteries Magnetic Resonance Angiography Patients Physicians Punctures X-Ray Computed Tomography
2
3D Rotational Angiography for Intracranial Aneurysm Characterization
During a 2-year period (2006−2007), 3D rotational digital subtraction angiography images were collected for patients with saccular terminal or sidewall intracranial IAs treated at Millard Fillmore Gates Hospital. All images collected were examined for suitability to be included in the study. Because 3D data reconstructed from rotational angiographic images (as opposed to two-dimensional [2D] images) were used in this study, we could only include cases in which the rotational angiographic images were of sufficient quality for accurate segmentation and reconstruction. Forty-five consecutive patients with 25 unruptured and 20 ruptured aneurysms met these criteria. Sixteen aneurysms (11 unruptured, 5 ruptured) were classified as saccular sidewall lesions, and 29 aneurysms (14 unruptured, 15 ruptured) were classified as saccular terminal lesions by the treating neurosurgeons. The aneurysm location and the age and sex of the patients were known. Approval for the collection and review of data was obtained from the Institutional Review Board at the University at Buffalo.
The 3D angiography images were obtained with a Toshiba Infinix VFi/BP frontal C-arm system (frame rate, 25 frames/s; rotation rate, 50 degrees/s; field of view: 9 inches; Toshiba America Medical Systems, Inc., Tustin, CA), yielding an image stack of 5123 pixels with a resolution of 0.19 to 0.25 mm/pixel. 3D reconstruction in surface-triangulation format and isolation of the region of interest (IA plus adjacent vessels) were performed using in-house software based on the open-source Visualization Tool Kit libraries. To allow accurate geometry measurements of both the aneurysm and the parent vessel, they were computationally separated at the IA neck using cutting tools in ANSYS ICEM CFD software (ANSYS, Inc., Canonsburg, PA). The IA neck plane was defined to our best ability as the location from where the aneurysmal sac pouched outward from the parent vessel. The 3D IA and parent vessel geometries were then analyzed to provide the various morphology parameters using custom algorithms programmed in MATLAB R2007a (MathWorks, Inc., Natick, MA). Finally, statistical analysis of the obtained data was performed using standard software tools (Microsoft Excel 2003, MATLAB R2007a, SPSS 15.0).
Dhar S., Tremmel M., Mocco J., Kim M., Yamamoto J., Siddiqui A.H., Hopkins L.N, & Meng H. (2008). Morphology Parameters for Intracranial Aneurysm Rupture Risk Assessment. Neurosurgery, 63(2), 185-197.
Publication 2008
Aneurysm Aneurysm, Ruptured Angiography Angiography, Digital Subtraction Blood Vessel Buffaloes Ethics Committees, Research isolation Neck Neurosurgeon Parent Patients Reading Frames Reconstructive Surgical Procedures
3
Functional Outcomes of Stroke Intervention
The primary outcome was the modified Rankin Scale (mRS) score,12 (link) which was assessed as part of usual care for all patients with stroke in all centres. The mRS score is a common measure of patient functional outcome after stroke, ranging from 0 (no symptoms) to 6 (death). Study staff were instructed to assess mRS scores at 90 days (range 14 days either way). Secondary outcomes were excellent functional outcome (mRS score 0-1), good functional outcome (mRS score 0-2), and favourable functional outcome (mRS score 0-3) at 90 days (range 14 days either way); score on the extended thrombolysis in cerebral infarction scale at the end of the intervention procedure; National Institutes of Health Stroke Scale (NIHSS) score 24-48 hours after intervention; and complications that occurred during intervention, hospital admission, or the three months’ follow up period.
We obtained relevant images (baseline non-contrast computed tomography, baseline computed tomography angiography, interventional digital subtraction angiography, and follow-up imaging), which were stored in an imaging database (XNAT; Neuroinformatics Research Group, St Louis, MO) and subsequently analysed by an imaging core laboratory.
Jansen I.G., Mulder M.J, & Goldhoorn R.J. (2018). Endovascular treatment for acute ischaemic stroke in routine clinical practice: prospective, observational cohort study (MR CLEAN Registry). The BMJ, 360, k949.
Publication 2018
Angiography, Digital Subtraction Cerebral Infarction Cerebrovascular Accident Computed Tomography Angiography Fibrinolytic Agents Patients X-Ray Computed Tomography
4
Acute Ischemic Stroke Subtyping and Complex Aortic Plaque
Subjects for this study were drawn from consecutive patients with acute ischemic stroke who were registered in the Yonsei Stroke Registry [15 (link)]. The Yonsei Stroke Registry is a prospective hospital-based registry of patients with cerebral infarction or transient ischemic attack within 7 days after symptom onset [16 (link)]. During admission, all patients were evaluated according to the standard stroke evaluation that includes brain imaging (computed tomography and/or magnetic resonance imaging [MRI]), vascular imaging studies (digital subtraction angiography, MR angiography, or computed tomography angiography), plain chest X-ray, 12-lead electrocardiography and cardiac echocardiography including TEE. Stroke subtype was determined according to the Trial of Org 10172 in Acute Stroke Treatment (TOAST) classification [17 (link),18 (link)]. Briefly, large artery atherosclerosis is defined as significant (≥50%) stenosis of the large artery relevant to the acute infarction. The presence of complex aortic plaque (CAP) was considered as one form of large artery atherosclerosis. Cardioembolism is defined as at least one potential cardiac source of embolism based on the TOAST classification. A patient with lacunar infarction should have one of the classic clinical lacunar syndromes and a relevant subcortical hemispheric or brain stem lesion with diameter <1.5 cm [16 (link)]. Besides above method of the TOAST classification, we reclassified the TOAST classification. In that reclassification, CAPs were not considered as large artery atherosclerosis. The Institutional Review Board of Severance Hospital, Yonsei University Health System, approved this study and waived the need for patient informed consent because of the retrospective design and observational nature of the study.
Song T.J., Kim Y.D., Yoo J., Kim J., Chang H.J., Hong G.R., Shim C.Y., Song D., Heo J.H, & Nam H.S. (2016). Association between Aortic Atheroma and Cerebral Small Vessel Disease in Patients with Ischemic Stroke. Journal of Stroke, 18(3), 312-320.
Publication 2016
Acute Cerebrovascular Accidents Acute Ischemic Stroke Angiography Angiography, Digital Subtraction Aorta Arteries Atherosclerosis Blood Vessel Brain Brain Stem Cerebral Infarction Cerebrovascular Accident Computed Tomography Angiography Echocardiography Electrocardiography, 12-Lead Embolism Ethics Committees, Research Heart Infarction Infarction, Lacunar Inpatient Org 10172 Patients Radiography, Thoracic Senile Plaques Stenosis Stroke, Lacunar Transient Ischemic Attack X-Ray Computed Tomography
5
Neuroradiological Assessment of Ischemic Stroke
Twenty one observers (20 interventional neuroradiologists and one interventional neurologist) at an imaging core laboratory assessed the images. The observers were blinded to all clinical findings, with the exception of clinical assessment of the occlusion location in case of baseline non-contrast computed tomography, and were assigned a random subset of images to assess. Before assessment began the observers were provided with guidelines including relevant definitions. In separate sessions, the observers evaluated ASPECTS on baseline non-contrast computed tomography13 (link); occluded arterial segment, clot burden score,14 (link) and collateral score15 (link) on baseline computed tomography angiography; extended thrombolysis in cerebral infarction on digital subtraction angiography16 (link); and presence of intracranial haemorrhage on follow up non-contrast computed tomography.17 (link)
ASPECTS is graded from 0 to 10, with 1 point subtracted from 10 for any evidence of early ischaemic changes in each defined region on non-contrast computed tomography.13 (link) We graded collaterals on a 4 point scale, with 0 for absent collaterals (0% filling of the vascular territory downstream of the occlusion), 1 for poor collaterals (>0% and ≤50% filling of the vascular territory downstream of the occlusion), 2 for moderate collaterals (>50% and <100% filling of the vascular territory downstream of the occlusion), and 3 for excellent collaterals (100% filling of the vascular territory downstream of the occlusion).15 (link) The extended thrombolysis in cerebral infarction score ranges from 0 (no antegrade reperfusion of the occluded vascular territory) to 3 (complete antegrade reperfusion of the occluded vascular territory).16 (link) The score includes grade 2C (slow flow in a few distal cortical vessels or presence of small distal cortical embolisms, corresponding to 90-99% reperfusion). To reach a score of 2B or higher, it was mandatory to complete digital subtraction angiography runs including anteroposterior and lateral views after endovascular treatment. If a lateral view was missing, 2A was the highest possible score. We classified intracranial haemorrhage on follow-up imaging according to the Heidelberg criteria.17 (link)
Jansen I.G., Mulder M.J, & Goldhoorn R.J. (2018). Endovascular treatment for acute ischaemic stroke in routine clinical practice: prospective, observational cohort study (MR CLEAN Registry). The BMJ, 360, k949.
Publication 2018
Angiography, Digital Subtraction Arteries Blood Vessel Cerebral Infarction Clotrimazole Computed Tomography Angiography Cortex, Cerebral Dental Occlusion Embolism Fibrinolytic Agents Intracranial Hemorrhage Neurologists Reperfusion Signs and Symptoms X-Ray Computed Tomography

Most recents protocols related to «Angiography, Digital Subtraction»

1
Mechanical Thrombectomy for Acute CCA Occlusion
Between September 2016 and April 2021, seven consecutive patients (three females and four males, average age of 78.1 years, ranging from 69 to 87 years) with acute CCA occlusion, four on the right side and three on the left side, underwent MT. The pretreatment modified Rankin Scale (mRS) score was 0 in five patients, 2 in one patient with an earlier cerebral infarct, and 3 in another with chronic heart failure.
All patients met the criteria for age (age ≧18 years), groin puncture within 6 hours after stroke onset, a diffusion-weighted imaging Alberta Stroke Program Early Computed Tomography Score (DWI-ASPECTS) of ≧6 on brain DWI magnetic resonance images (MRI), a National Institutes of Health Stroke Scale (NIHSS) score of ≧6, and CCA thrombus progression confirmed on digital subtraction angiography.
Pre-procedure data included the DWI-ASPECTS at the time of admission and the CCA diameter at the occlusion site calculated by comparing it with the outer diameter of the balloon guide catheter (BGC). The treatment characteristics were the minutes from puncture to reperfusion, intravenous alteplase treatment, direct aspiration with a BGC, the number of passes required for reperfusion, femoral sheath obstruction during the procedure, and recanalization improvement determined with the thrombolysis in cerebral infarction (TICI) grade.19 ,20 ) The post-procedure imaging characteristics were carotid artery stenosis after MT and intracranial hemorrhage. The clinical outcomes were evaluated based on the mRS score obtained 3 months after surgery and a diagnosis of symptomatic hemorrhage as defined by the criteria promulgated by the European Cooperative Acute Stroke Study-2 (ECASS-2).21 )
IDEGUCHI M., KIM K., SUZUKI M., KANEKO J., SATO S., SHIROKANE K, & MORITA A. (2023). Mechanical Thrombectomy for Acute Common Carotid Artery Occlusion. Neurologia medico-chirurgica, 63(2), 73-79.
Publication 2023
Acute Cerebrovascular Accidents Alteplase Angiography, Digital Subtraction Brain Carotid Stenosis Catheters Cerebral Infarction Cerebrovascular Accident Congestive Heart Failure Dental Occlusion Diagnosis Diffusion Disease Progression Europeans Females Femur Fibrinolytic Agents Groin Hemorrhage Intracranial Hemorrhage Intravenous Infusion Males Operative Surgical Procedures Patients Punctures Reperfusion Thrombus X-Ray Computed Tomography
2
Retrospective Study of Unruptured VADA
A total of 16 patients with unruptured intracranial VADA from January 2017 to May 2021 in our institution were retrospectively included and reviewed. Digital subtractive angiography (DSA), magnetic resonance (MR), and computerized tomography (CT) angiography are usually used to aid in the diagnosis of VADA. The electronic medical record system provided the data on the patients. The Institutional Review Board of Yunnan First People's Hospital approved this study. Patients' therapeutic decisions (FD, stent-assisted coil embolization, or surgical clipping) were made after considering treatment risks, benefits, and the condition of patients. Patient informed consent is required from every patient before the procedure.
Lu X., Zhang Y., Zhou H., Jian L., Yin S., Li T, & Huang W. (2023). Flow diverters in the treatment of unruptured vertebral artery dissecting aneurysm: A single-center experience. Frontiers in Neurology, 14, 1050619.
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Publication 2023
Angiography, Digital Subtraction Computed Tomography Angiography Diagnosis Embolization, Therapeutic Ethics Committees, Research Magnetic Resonance Imaging Operative Surgical Procedures Patients Stents
3
Aneurysmal Subarachnoid Hemorrhage Inclusion Criteria
Inclusion criteria included a diagnosis of SAH based on CT or the presence of xanthochromia in cerebrospinal fluid (CSF) in patients older than 18 years who were admitted within 48 h of symptoms onset (bleed day 0). Exclusion criteria included traumatic SAH, arteriovenous malformation (AVM), or other non-aneurysmal vascular lesions identified on digital subtraction angiography, the presence of auto-immune diseases, pro-inflammatory conditions like malignancy and pregnancy, and the diagnosis of isolated perimesencephalic SAH. A flowchart depicting the patients selected for analysis is shown in Supplementary Figure 1.
Gonzalez Gomez H., Savarraj J.P., Paz A.S., Ren X., Chen H., McCullough L.D., Choi H.A, & Gusdon A.M. (2023). Peripheral eosinophil trends and clinical outcomes after non-traumatic subarachnoid hemorrhage. Frontiers in Neurology, 14, 1051732.
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Publication 2023
Aneurysm Angiography, Digital Subtraction Arteriovenous Malformation Blood Vessel Diagnosis Immune System Diseases Inflammation Malignant Neoplasms Patients Pregnancy
4
Hepatic Artery Embolization in Rabbits
The embolization procedure was performed under the guide of digital subtraction angiography (Siemens AXIOM Artis FA DSA, Siemens Medical Systems, Erlangen, Germany). Rabbits were anesthetized as described earlier. Vascular access was achieved in the femoral artery through surgical cut down. Celiac angiography was performed to identify the hepatic arterial anatomy and the feeder artery of the tumor using a 3-F catheter (Cook, Bloomington, India). The left hepatic artery, which exclusively supplies blood flow to the tumor, was catheterized selectively. When the catheter was adequately positioned in the left hepatic artery after celiac arteriography was performed, MVLs or 0.9% sodium chloride was injected carefully into the artery according to different groups. Digital spot images were obtained after embolization. The catheter was then removed, and the femoral artery was ligated.
Tang H., Cao C., Zhang G, & Sun Z. (2023). Impact of particle size of multivesicular liposomes on the embolic and therapeutic effects in rabbit VX2 liver tumor. Drug Delivery, 30(1), 1-16.
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Publication 2023
Angiography Angiography, Digital Subtraction Arteries Arteriography Blood Vessel Catheters Embolization, Therapeutic Femoral Artery Hematologic Neoplasms Hepatic Artery Lanugo Neoplasms Operative Surgical Procedures Oryctolagus cuniculus Sodium Chloride
5
Unruptured ICA Aneurysms Treated with FD Stents
This is a retrospective, single-center, observational study evaluating patients diagnosed with unruptured intracranial internal carotid artery (ICA) aneurysms treated with an FD stent between January 1, 2014, and January 1, 2020, at the Fundación Oftalmológica de Santander–Clínica Ardila Lülle. We analyzed and anonymized patient information that may identify a patient from clinical records, medical consultations, and follow-up imaging records of the patients enrolled. Patients over 18 years of age with a diagnosis of unruptured small (<5 mm), medium (5–10 mm), large (10–25 mm), or giant (>25 mm) aneurysms of the intracranial internal carotid segment treated with FDs in that period were included. In addition, 1-year digital subtraction angiography (DSA) results were mandatory to assess the occlusion rate. Incomplete data in the database, patients with no follow-up, and a history of aneurysm rupture less than 30 days before treatment were excluded.
López-Callejas O., Ortiz-Giraldo A.F., Vera D.D., Ramirez-Rojas D.A., Villamizar-Barahona A.B., Ferreira-Prada C.A., Galvis M., Vargas-Pérez O., Serrano-Gómez S., Reyes-Gonzalez A, & Mantilla D. (2023). Flow Diverter Treatment for Non-Ruptured Carotid Aneurysms: Efficacy and Safety. Neurointervention, 18(1), 23-29.
Publication 2023
Aneurysm Angiography, Digital Subtraction Carotid Arteries Dental Occlusion Diagnosis Gigantism Internal Carotid Arteries Intracranial Aneurysm Patients Stents

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Allura xper fd20 by Philips
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Progreat by Terumo
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Lipiodol by Guerbet
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More about "Angiography, Digital Subtraction"

Digital subtraction angiography (DSA) is a cutting-edge radiographic technique that enhances the visualization of blood vessels and other structures.
This process involves electronically subtracting the image of the body part before the injection of a radiopaque contrast medium, such as Lipiodol, Omnipaque 350, or Visipaque.
This allows for the clear depiction of the blood vessels, making it a valuable tool in the diagnosis and treatment of various cardiovascular and vascular conditions.
The latest advancements in this field have led to improved image quality, reduced radiation exposure, and enhanced diagnostic capabilities.
Researchers in this area continue to explore new techniques and technologies, including the use of Allura Xper FD20, Progreat, Artis Zee, and Innova 3100 systems, to further optimize the usefulness of digital subtraction angiography in clinical practice.
DSA is also known as digital angiography, electronic subtraction angiography, or simply DSA.
It is commonly used to assess and diagnose conditions such as peripheral artery disease, aortic aneurysms, and cerebrovascular disorders.
The use of contrast agents like Lipiodol Ultra-Fluide and Epirubicin can also enhance the imaging of specific structures or pathologies.
With the continued evolution of DSA technology, healthcare professionals now have access to more precise and efficient tools for the diagnosis and management of vascular and cardiovascular conditions.
These advancements have the potential to improve patient outcomes and streamline clinical workflows.