Application Of Digital Subtraction Angiography Research Articles

Application of Digital Subtraction Angiography in Predicting the Outcomes of Intraoperative Hemorrhage of Juvenile Nasopharyngeal Angiofibroma

Juvenile nasopharyngeal angiofibroma (JNA) is a very rare hemorrhagic vascular tumor that predominantly affects adolescent boys. The tumor is relatively large when detected, and the risk of intraoperative bleeding is high. We aimed to examine factors associated with intraoperative blood loss in JNA surgery. Thirteen patients with JNA who underwent surgery at the Jikei University Hospital between 2009 and 2020 were retrospectively reviewed, and factors associated with blood loss were examined by single regression analysis. The mean age was 20.8±7.7years. Preoperative angiographic images were evaluated in 9 of the 13 cases. The 6 patients with the largest bleeding volumes, all had residual nutrient vessels from the internal carotid artery (ICA), with an average number of 2.5 vessels. The mean blood loss of patients with residual nutrient vessels from the ICA was 3037±2568mL. Single regression analysis of bleeding volume against the number of remaining nutrient vessels from the ICA and the total peak contrast density of nutrient vessels (Cmax) standardized by region of interest showed that the coefficient was positive (P<0.05 for both), confirming a significant correlation between the 2, respectively. The amount of bleeding significantly correlated with the number of remaining nutrient vessels from the ICA after preoperative embolization and with the total Cmax/region of interest. The ability to predict the amount of preoperative blood loss using this study will facilitate proposals for external incisions in patients with JNA.

The Recipient Vessel Hemodynamic Features Affect the Occurrence of Cerebral Edema in Moyamoya Disease After Surgical Revascularization: A Single-Center Retrospective Study.

ObjectiveIn moyamoya disease (MMD) with direct or combined revascularization, the initially hemodynamic recipient features are likely one of the main causes of acute hemodynamic disruption. Previous studies have explored the relationship between recipient diameter or flow velocity and postoperative complications, but there are still no optimal selection criteria with multiple potential recipient vessels. Cerebral edema is one of the most common radiological manifestations in the acute postoperative period. This study assessed the hemodynamic characteristics of cortex vessels related to postoperative cerebral edema.MethodsAll patients who had undergone direct or combined revascularization with preoperative digital subtraction angiography (DSA) between 2019 and 2021 were eligible for inclusion in this study. The application of DSA was performed and regular radiological examinations were employed after surgery. DSA was analyzed with the hemodynamic features within chosen recipient vessels. Cerebral edema was identified as a low-density image on CT or high signaling in the MRI T2 phase. The recipient hemodynamic characteristics and demographic presentation, as well as clinical data, were retrospectively analyzed in this study.ResultsA total of 103 patients underwent direct or combined revascularization with preoperative DSA. The mean age of this enrolled cohort was 44.31 ± 10.386 years, in which bilaterally involved MMD accounted for the main part. The preliminary correlation analysis found preoperative disease period (p = 0.078), recipients observed in angiography (p = 0.002), and surgery on the left (p = 0.097) may be associated with cerebral edema. The following regression analysis confirmed low occurrence of cerebral edema was accompanied by recipients observed in angiography (p = 0.003). After subdividing by flow direction and hemodynamic sources, the incidence rate of anterograde direction, anterior sources, and posterior sources were significantly lower than undetected recipients.ConclusionsCerebral edema is a common radiological manifestation in MMDs after surgery. In this study, the observation in angiography reliably identifies a variety of physiological or pathological recipient detection, flow direction, and hemodynamic sources in patients with MMD after revascularization, which indicates the selection strategy of potential recipients and highlights the importance of recipient observability in DSA. Meanwhile, vascular conditions determined by recipient hemodynamics meditate the occurrence of postoperative cerebral edema.

Application of digital subtraction angiography in canine hindlimb arteriography

Research in the field of lower extremity vascular disease has increased in popularity over the years. To adequately characterize and validate the effectiveness of vascular interventions, in vivo experimentation in large animals is required. Thus, it is necessary to find a method to detect the shape and density of blood vessels in the lower extremities that can evaluate and verify the treatment measures' effectiveness and have high accuracy and repeatability. This study characterized factors that determined both the accuracy and overall value of digital subtraction angiography in lower limb arteriography using a canine animal model. Six beagle dogs were anesthetized and immobilized on the motorized table. The femoral artery was accessed using an indwelling needle. A bolus of contrast agent was injected into the access site, and digital subtraction angiography with bolus chase technology was used to collect contrast images for analysis. At the end of the procedure, the anesthetized dogs were euthanized using an overdose of potassium chloride. After confirming the euthanasia of the dogs, the cadavers were taken to the experimental animal center of Xinjiang Medical University and processed by qualified institutional personnel. The final arteriographic images of the hind limbs from all six dogs were precise, and the branches of small vessels could be distinguished without any visible artifacts. These results suggested that arteriography using digital subtraction angiography could reveal the shape and density of blood vessels in canine animal models. This method has great potential to significantly improve research related to limb ischemia due to its simple and reproducible results.

Application of Digital Subtraction Angiography in Reconstruction of Plantar Forefoot With Reverse Medial Plantar Flap.

The reverse medial plantar flap (RMPF) raised from the nonweight-bearing region of the plantar foot represents a viable option for the soft tissue defect in planter forefoot. The anatomical basis of RMPF is the complex anastomotic branches between medial plantar artery (MPA) and deep plantar arch. Those anastomotic branches have high variation rate and may be damaged by trauma such as electric injury. Therefore, it is very important to know whether those anastomotic branches are present and intact before harvesting RMPF. Five patients with soft tissue defect in planter forefoot were enrolled into the study. The digital subtraction angiography (DSA) was performed to evaluate the plantar hemodynamics in the ipsilateral foot. The RMPF was harvested only after the anastomotic connections between MPA and deep plantar arch was confirmed. Anastomosis between superficial branch of MPA and deep plantar arch was observed in all DSA examinations. All 5 patients received the repair of soft tissue defect in plantar forefoot with RMPF. All flaps survived completely. The DSA can effectively evaluate the blood supply basis of RMPF and provide imaging evidence for the design and harvest of the flap. The main anatomical basis of RMPF is the anastomotic connections between superficial branch of MPA and deep plantar arch.

Microsurgical Management of Basilar Artery Apex Aneurysms

asilar artery apex aneurysm is a critical nervous system vascular disease and accounts for 5% of central nervous B system aneurysms. With improvements in clinical diagnosis and the application of digital subtraction angiography, increasing numbers of basilar artery apex aneurysms are being diagnosed, and the choice of surgical treatment versus conservative observation becomes a concern. Nanda et al. present their experience with consecutively operated complex basilar apex aneurysms. Concerning the management of large or giant, wideneck, and calcified or thrombosed aneurysms, the authors conclude that microneurosurgery is still a useful alternative to endovascular therapy.

A LabVIEW Platform for Preclinical Imaging Using Digital Subtraction Angiography and Micro-CT

CT and digital subtraction angiography (DSA) are ubiquitous in the clinic. Their preclinical equivalents are valuable imaging methods for studying disease models and treatment. We have developed a dual source/detector X-ray imaging system that we have used for both micro-CT and DSA studies in rodents. The control of such a complex imaging system requires substantial software development for which we use the graphical language LabVIEW (National Instruments, Austin, TX, USA). This paper focuses on a LabVIEW platform that we have developed to enable anatomical and functional imaging with micro-CT and DSA. Our LabVIEW applications integrate and control all the elements of our system including a dual source/detector X-ray system, a mechanical ventilator, a physiological monitor, and a power microinjector for the vascular delivery of X-ray contrast agents. Various applications allow cardiac- and respiratory-gated acquisitions for both DSA and micro-CT studies. Our results illustrate the application of DSA for cardiopulmonary studies and vascular imaging of the liver and coronary arteries. We also show how DSA can be used for functional imaging of the kidney. Finally, the power of 4D micro-CT imaging using both prospective and retrospective gating is shown for cardiac imaging.

Comparative study of multi-slice CT angiography with digital subtraction angiography in the blood supply of meningiomas

Evaluation of multi-slice CT angiography (MSCTA) and digital subtraction angiography (DSA) was made through the comparison of the two methods in detecting the blood supply of meningiomas, providing further clues for the improved application of MSCTA and DSA in the blood supply of meningiomas. In this study, 20 patients with meningiomas underwent CT angiography by 16-slice spiral CT and inspection 1 week later using DSA. The blood supply of the meningiomas (including the tumor feeding arteries, draining veins, venous sinuses, vessels around the tumor and skull-shaped images, such as comparative evaluation) was compared. The results showed that MSCTA and DSA inspection clearly depicted tumor feeding arteries, draining veins and venous sinuses in all 20 patients. DSA was slightly more effective than MSCTA in displaying fine branches, and DSA had obvious advantages over MSCTA in displaying vessels near the skull. In the display of the tumor's compression and pushing over its peripheral vasculature, MSCTA had the three-dimensional advantage, although in displaying parasagittal sinus meningiomas, it may overestimate the presence of venous sinus invasion due to the impact of bone structure. This does not affect DSA. MSCTA accurately assesses the relationship between the tumor and the bone, and provides three-dimensional images for the pre-operative simulation of surgical approaches. Taken together, MSCTA and DSA are both able to provide important information, such as accurate visualization of tumor-feeding arteries, draining veins and venous sinuses, with high consistency. MSCTA is more advantageous in the depiction of three-dimensional relationships between the tumor and peripheral vessels and skull. Compared to DSA, MSCTA is non-invasive, faster and less costly.

Application of DSA (Digital Subtraction Angiography) to The Cerebral Vessel Examinations

Application of DSA (Digital Subtraction Angiography) to The Cerebral Vessel Examinations

Military Applications of Digital Subtraction Angiography

Military Applications of Digital Subtraction Angiography

Cardiac applications of digital subtraction angiography.

Recent developments in digital computer technology have enabled direct digital acquisition of radiographic images at spatial and temporal resolutions similar to that of cineradiography. Initially intended as a means of performing peripheral angiography, digital subtraction angiography has been increasingly applied to cardiac catheterization procedures. Advantages of cardiac digital subtraction angiography include the capabilities to: immediately replay, magnify and enhance angiographic studies during coronary artery interventions, perform left ventriculography with peripheral contrast injections and direct left ventriculography with substantially reduced contrast doses, perform bypass graft visualization using aortic root contrast injection, assess relative regional coronary blood flow and facilitate the quantification of ventriculographic and coronary stenosis parameters. Clinical comparisons of standard cineradiographic and digital angiographic studies have demonstrated very similar results.

Applications of Digital Subtraction Angiography in Cardiovascular Diagnosis

Both intravenous and intra-arterial DSA have widespread applications in the field of cardiovascular diagnosis. The definition of carotid artery stenosis or severe peripheral vascular disease in the patient undergoing coronary artery bypass surgery might dictate the need for simultaneous carotid and coronary artery surgery or demonstrate the best route for insertion of an intra-aortic balloon. DSA also might find further application in the definition of thoracic aortic dissection, thoracic aortic trauma, and coarctation of the thoracic aorta, as well as in showing the adequacy of repair of thoracic coarctation in patients who remain hypertensive postoperatively. Left ventricular imaging using intravenous or intraventricular injections of contrast material provides an accurate method of calculating ejection fraction and an excellent picture of left ventricular wall motion. In addition, because smaller amounts of contrast material may be used for intraventricular infections, patients with renal failure or severe impairment of the left ventricle might fare better with the reduced contrast load. Multiple ventriculograms can be performed following interventions such as pacing or exercise to allow a more adequate definition of left ventricular performance. Intravenous DSA still has not achieved satisfactory visualization of the coronary arteries or coronary artery bypass grafts. However, aortic root injections of contrast material can provide adequate definition of these structures and has been recommended as a screening technique for coronary disease in patients undergoing arteriography for other vascular disease. Current work on the development of DSA techniques for the quantitation of coronary artery blood flow and myocardial perfusion is quite promising. Accurate, reproducible measurement of coronary artery blood flow, patterns of myocardial perfusion, and areas of myocardium supplied by specific coronary vessels with obstructions may soon provide physiologic information about anatomically defined coronary artery disease. A variety of congenital heart defects have been defined by intravenous DSA. Shunt lesions such as atrial septal defects, ventricular septal defects, and patent ductus arteriosus have been defined anatomically, and the severity of their shunts has been estimated by placing windows of interest over the various cardiac chambers. It is possible that certain congenital malformations might be studied adequately by intravenous DSA, eliminating the need for cardiac catheterization.(ABSTRACT TRUNCATED AT 400 WORDS)

Digital subtraction angiography: current clinical applications.

The applications of digital subtraction angiography (DSA) in neurologic diagnosis have been evolving as clinical experience with this technology accumulates. Initial enthusiasm with the intravenous contrast material injections has been tempered by often equivocal results. Intravenous DSA (IV-DSA) is still an accurate screening technique for extracranial carotid atherosclerosis, comparable to duplex ultrasound. Intracranial imaging is less satisfying with intravenous injections but reliable information is available in the assessment of the venous sinuses and parasellar internal arteries. The future of DSA lies with intraarterial contrast injections, as this technique substantially decreases the risks and costs of definitive cerebrovascular investigation.

Digital subtraction angiography (DSA) in neuroradiology.

DSA ranks among the modern imaging procedures which owe their development to the advances made in computer technology. Thanks to i.v. contrast injection, it has become possible to evaluate a lesion in the cervical vessels in at least 80% of cases and in 60% of cases when intracranial vessels are concerned. Intra-arterial contrast injection renders the diagnostic yield of DSA equal to that of conventional angiography with the benefit that the required contrast volumes are low and that the catheter need not always be placed selectively. Intravenous contrast injection is required with patients advanced in age, when critical cardiovascular conditions prevail, when the arterial access routes are completely occluded or in the case of postoperative checks of the cervical vessels. Although its field of application remains restricted, particularly in the case of intravenous contrast injection, the clinical application of DSA appears well established and its advantages are undisputed. Examples are given to demonstrate the clinical boundaries set to this new imaging procedure based on i.v. and intra-arterial contrast injection.

Clinical Application of Digital Subtraction Angiography

Clinical Application of Digital Subtraction Angiography

Potential applications of digital angiography in GU imaging.

A brief review of the development and current and potential applications of digital subtraction angiography to imaging of the urinary tract is presented. The technique is described in a general way, and the potential applications and drawbacks of the method in its current form are illustrated.