Portable digital subtraction angiography in the operating room and intensive care unit

A simple, inexpensive method of portable digital subtraction angiography (DSA) using an image processor (Sigma X), still-videorecorder and control panel combined with a surgical x-ray television unit can provide real time subtraction images on the monitor. This portable DSA unit was used in 161 cases (130 in the operating room and 31 in the intensive care unit). In the operating room it is useful: 1) to confirm patency of the parent artery and its branches after aneurysm clipping, 2) to identify feeding arteries of arteriovenous malformation and to confirm total extirpation, 3) to confirm the patency of extracranial-intracranial bypass, 4) to confirm patency of the internal carotid artery and absence of flap formation after carotid endarterectomy. In the intensive care unit, it is particularly useful for visualizing cerebral vasospasm after subarachnoid hemorrhage and recanalization of an occluded major intracranial artery. Absence of intracranial circulation can be demonstrated in patients with suspected brain death.