A prospective comparison of intra-arterial digital subtraction and conventional angiography prior to lower extremity...

Prior to lower extremity revascularization, patients underwent CA or IADSA as the only radiologic study. A total of 30 patients were entered into each group and subsequently underwent a reconstructive procedure. Each study in the CA group was deemed accurate at the time of surgery, in assessing suitability of vessels for anastomosis. Of the patients undergoing surgery based exclusively on IADSA, 5 were noted in whom this examination provided insufficient detail or were misleading, resulting in attempted reconstructions at inappropriate sites. These results were statistically significant and indicate that IADSA should not be used as the only imaging technique in the preoperative evaluation of lower extremity vascular disease. IADSA is most useful as a complementary technique to CA and should be performed during the same examination when the latter fails to identify distal runoff vessels. In the majority of cases, CA alone will provide sufficient information and should be used as the initial contrast study.