Intravenous digital subtraction angiography: application to cerebrovascular surgery

Intravenous digital subtraction angiography (DSA) was used to evaluate the extracranial and/or intracranial arteries of 87 patients with suspected cerebrovascular disorders. The examinations were performed on either an inpatient or an outpatient basis. Renografin-76 was injected into an arm vein through an angiocatheter. Extracranial examinations accurately demonstrated major artery disease such as carotid artery occlusion, stenosis, and ulceration. Intracranial examinations demonstrated an aneurysm in 9 of 10 patients and an arteriovenous malformation in 5 patients. The technique was useful in assessing the results of cerebrovascular procedures such as carotid endarterectomy, superficial temporal artery to middle cerebral artery bypass, and the obliteration of vascular anomalies. DSA also excluded the presence of an intrasellar aneurysm and showed the location of the intracranial arteries before trans-sphenoidal surgery. The findings of the DSA examinations correlated closely with the findings of conventional angiography.