The use of digitized intravenous angiography in a clinical setting: A retrospective review of 58 patients

Abstract

Digitized intravenous angiography (DIVA) is a frequently used alternative to conventional intra-arterial angiography for the evaluation of cerebrovascular disease. In an attempt to identify factors that may increase the diagnostic capacity of DIVA, a retrospective study of 58 patients evaluated by DIVA for cerebrovascular disease was performed. The reason for the DIVA study was the presence of focal symptoms in 25 patients and nonfocal or vertebrobasilar symptoms in nine. Twenty-four patients were asymptomatic. DIVA was found to be adequately diagnostic in 37 patients (64%), and further evaluation was required in 21 (36%). When the 42 patients who had ocular pneumoplethysmography (OPG-Gee) results available were classified according to their presenting symptoms, 85% of those with focal symptoms and positive OPG-Gee had a diagnostically successful DIVA study. A high DIVA accuracy rate was also obtained in the asymptomatic patients, whether the OPG-Gee results were positive (60%) or negative (78%). The category of patients for whom the DIVA was the least successful was the group with nonfocal or vertebrobasilar symptoms. As many as 56% of these patients required additional testing. Thus it appears that the yield of diagnostic DIVA is increased when the clinical presentation and noninvasive testing are considered. A prospective study is underway to further verify this hypothesis.