[Application of digital subtraction angiography (DSA) in the neurosurgical field]

Intraarterial digital subtraction angiography (DSA) was applied 44 times to 39 neurosurgical cases. We emphasize the advantage of DSA in relation to conventional angiography. The examination consisted of 25 aortography and 19 selective arteriography. By single small dose injection of contrast medium using DSA, aortic arch and thoracic major vessels were well visualized, so that we could obtain useful information for catheterization to the selective artery. High time resolution of DSA made possible to recognize dynamics of circulation in very short interval, especially in the case of subclavian steal syndrome and right aortic arch. Major four vessels in the cervical region could be visualized by single injection of contrast medium using DSA. Stenosis of carotid artery was recognized by DSA as well as conventional angiography. By aortic injection using DSA, circulatory dynamics of intracranial vessels including collateral circulation were recognized especially in the case of moyamoya disease. Gradual injection of small dose contrast medium reduced jet-effect of the catheter tip and enabled the selective arteriography. Real time display of DSA reduced the time required for examination and enabled repeated angiography to recognize the change of hemodynamics under the different limb position in the case of thoracic outlet syndrome.