Digital angiography of pulsatile masses in the neck

Twenty-six consecutive patients with pulsatile neck masses were studied with digital subtraction angiography (DSA) by venous injection, computed tomography (CT), and conventional direct angiography. The neck masses proved to be secondary to tortuous and ectatic carotid or subclavian arteries in 13 cases, resulted from subclavian artery aneurysms in three cases, and resulted from tumor in 10 cases. DSA alone was sufficient for diagnosis in 16 of 26 cases. CT was performed in 15 cases and was contributory in 10. It was most useful when a tumor was demonstrated or suspected on DSA. Conventional angiography was performed in six cases. It contributed no useful information when arteriosclerotic vascular changes were the source of the neck mass, and added useful diagnostic information in only two of 10 neck tumors.