Digital Intravenous Angiography Research Articles

Digital fluoroscopy and intravenous cardiac angiography for the detection of coronary artery disease in selected subjects. A feasibility study.

Thirty-seven thin patients (height/weight ratio >2.2 cm/kg) without prior myocardial infarction underwent digital subtraction fluoroscopy and intravenous digital subtraction cardiac angiography one day before they were scheduled to undergo coronary angiography. Eighteen (49%) had at least a 50% obstruction of a major coronary artery as shown on selective coronary cineangiograms; eight of these (44%) had three calcified coronary arteries as visualized by digital fluoroscopy, five (28%) had diagnostic wall-motion abnormality by digital ventriculography, and 15 (83%) had intravenous angiographic evidence of at least one severe (>50%) coronary obstruction. Seventeen (94%) of the 18 with severe selective angiographic obstructions had at least one calcified artery detected by the digital study. Seventeen (89%) of the 19 without angiographic evidence of severe disease had none of these three abnormalities visualized on their digital intravenous images. Intravenous cardiac angiography was more accurate for predicting proximal coronary, right coronary, and left anterior descending branch obstructions, than for distal coronary and left circumflex artery obstructions.

Digital intravenous angiography for the study of hemodialysis vascular access.

Digital intravenous angiography is a simple and safe procedure and can be performed on an outpatient basis. Poor function of a hemodialysis vascular access due to increased graft resistance, reduced arterial inflow or shunt steal can be evaluated by this technique. Complications of direct graft puncture or conventional arteriography can be avoided using digital angiography.

The place of digital intravenous angiography in cerebral infarcts.

The authors describe their technique of intravenous digital subtraction angiography (IVDSA) and discuss the results in cerebral infarcts. IVDSA is a good first stage examination for the recognition of stenosis or occlusion of cervical vessels to the brain, as it is an only marginally invasive and easy technique. It is, however, good neither for the study of focal cervical not of intracranial areas.

Spontaneous dissecting aneurysms of the internal carotid and vertebral arteries--two case reports.

Two patients had acute spontaneous dissection of both internal carotid arteries and of one or both vertebral arteries. One had angiographic signs suggestive of fibro-muscular dysplasia and both were on oral contraceptives. They were treated with high dose heparin and made a good clinical recovery. A digital intravenous angiography performed two to three months later showed a complete recanalization of arteries involved. These patients are similar to those reported as "idiopathic regressing arteriopathy" and "reversible angiopathy" which probably correspond to the same entity.

Complications of digital intravenous angiography: experience in 2488 cervicocranial examinations.

All complications were recorded from the initial 2488 cases studied with digital intravenous angiography (DIVA) at New York University Medical Center. Mechanisms of producing these reactions were categorized into procedure-related, contrast-medium-related, or disease-related. The complications included extravasation of contrast material into the arm (11 patients) and mediastinum (two), acute pulmonary edema (four), hypotension (23), thrombophlebitis (two), and grand mal seizure (one). Recommendations are made that would allow DIVA to be performed more safely.

Overview of Intracranial Applications of Digital Intravenous Angiography

The clinical utility of digital intravenous angiography (DIVA) in arteriosclerotic disease of the carotid arteries was reviewed in 86 patients. DIVA provides sufficient information for the evaluation of intracranial disorders in many individuals, particularly those with venous abnormalities. Arterial studies are still required when in-depth information is necessary with regard to abnormalities of the arterial system.

Occlusive vascular disease in asphyxiated newborn infants

Six full-term severely asphyxiated newborn infants underwent evaluation with digital intravenous angiography. All infants were comatose and flaccid and had seizures, depressed brainstem function, and signs of intracranial hypertension. An initial brain CT scan revealed diffuse hypodensities and compressed ventricles. Follow-up noncontrast CT scans showed areas of increased attenuation. Digital intravenous angiography demonstrated venous sinus thrombosis in five infants, two of whom also had arterial thrombosis, and hypervascularity in the sixth infant. Our data document that occlusive vascular disease is a prominent feature of severe perinatal asphyxia.

Digital intravenous angiography in the diagnosis of renal artery occlusion

Digital intravenous angiography (DIVA) proved to be highly accurate and sensitive in the diagnosis of six cases of renal artery occlusion. The impact of this new modality on the diagnosis and management of such patients is considered.

The effect of ischemia and isoproterenol on the pulmonary circulation in dogs. Analysis by digital intravenous angiography.

Slutsky RA, Gerber KH, Higgins CB. The effect of ischemia and isoproterenol on the pulmonary circulation in dogs: analysis by digital intravenous angiography. To assess the effects of ischemia and isoproterenol on the pulmonary circulation, eight open-chest dogs were studied by digital intravenous angiography. Dogs were instrumented with a left circumflex (LCX) coronary flow probe and occluder, left atrial catheter (three dogs), aortic catheter for pressure recordings, and electrocardiogram (ECG) leads to provide a gating signal. Both indicator dilution techniques and standard area-length measures of the central circulation were employed for determination of cardiac output, pulmonary blood volume (PBV), and pulmonary transit time (PTT). PTT lengthened after subtotal (2.7 ± 1.6 to 3.2 ± 1.2 seconds, P < .05) and total LCX occlusion (4.0 ± 1.0 seconds, P < .01 vs. control) and declined during isoproterenol administration (1.9 ± 0.7, P < .05 vs. control). PBV increased gradually with ischemia (from control value of 177 ± 75 ml to 179 ± 57 ml at subtotal occlusion to 241 ± 59 at total occlusion) but was significantly greater only with total occlusion (P < .01). Isoproterenol produced increases in PBV (197 ± 46 ml, P < .05 vs. control) due to increases in cardiac output (PTT shortened). In general, prolongations of PTT and increases in PBV were associated with gradual increases in LA pressure. The authors conclude that intravenous digital angiography may be used to assess hemodynamic changes in the pulmonary circulation. Acute ischemic heart failure is associated with increases in PBV (mean increase of 36%) and prolongation in PTT (mean increase of 48%).

Analysis of the pulmonary circulation using digital intravenous angiography.

We evaluated pulmonary transit time in dogs and humans using digital intravenous angiography. Digital data were acquired in both the control state and after isoproterenol was administered to alter the inotropic state. When compared with the control value, transit time was shortened with isoproterenol in both dogs and humans. The inter- and intraobserver variabilities were small (less than 4%), as were the variabilities in data obtained from two sequential injections (less than 5%). Digital analysis of the pulmonary circulation time is a simple technique that requires little image manipulation. This information may be obtained during standard digital cardiac studies, and it can assist in the analysis of cardiopulmonary dynamics.

Effects of acute incremental volume overload on cardiac chamber size, function, and the pulmonary circulation: Analysis by digital intravenous angiography

To assess the effects of acute incremental volume overload on cardiac size, function, and the pulmonary circulation, we studied six anesthetized dogs using intravenous digital angiography. Aortocaval (AC) fistulas were placed in four dogs, and fistulas in both a carotid and iliac artery were placed in two dogs. Data were obtained at four points: (1) control stage; (2) partial shunt (PS, where either AC partially open or iliac fistula was open and carotid fistula was closed); (3) full shunt (FS, AC shunt open or both iliac and carotid shunts open); and (4) control stage 2. Little change in heart rate (HR) or arterial pressure occurred. With FS, both mean pulmonary artery and wedge pressures increased ( p < 0.05); however, systemic and pulmonary vascular resistances declined. Cardiac output rose (1.54 ± 0.42 L/min at control) to 2.44 ± 0.84 L/min at PC ( p < 0.05 vs control) and to 3.13 ± 0.89 L/min at full shunt ( p < 0.01 vs control). Both left (0.40 ± 0.09 to 0.55 ± 0.10 to 0.66 ± 0.10, p < 0.05 and p < 0.01 vs control, respectively) and right (0.34 ± 0.10 to 0.40 ± 0.10 to 0.51 ± 0.09, the latter p < 0.01 vs control) ventricular ejection fractions rose, as did left (30.7 ± 13 ml to 35.1 ± 13 ml to 37.8 ± 13 ml, the latter p < 0.05 vs control) and right (37.4 ± 6.1 ml to 44.2 ± 16.6 ml to 51.4 ± 17 ml, the latter p < 0.01 vs control) ventricular end-diastolic volumes. Atrial volume (determined at ventricular end-systole) also increased (9.4 ± 3.6 ml to 11 ± 3.5 ml to 12.9 ± 4.3 ml, the latter p < 0.05 vs control). These increases in cardiac function and size occurred in association with a shortening of pulmonary transit time (5.4 ± 0.8 to 3.5 ± 0.7 seconds to 2.9 ± 0.5 seconds, the latter two p < 0.05 and p < 0.01 vs control, respectively), with no significant change in pulmonary blood volume. We conclude that acute volume overload produces cardiac chamber dilatation, along with increases in systolic function. Both pulmonary and systemic vascular resistance declined, and the transit time in the pulmonary circulation shortened. Digital intravenous ventriculography is a useful technique for the analysis of the central circulation during acute hemodynamic manipulations.

Evaluation of potential renal donors and renal allograft recipients: digital video subtraction angiography.

Digital video subtraction angiography is a safe, easily performed, outpatient procedure that was applied to evaluating the arterial anatomy of 11 potential renal donors and 22 examinations of 19 renal allograft recipients. Digital intravenous angiography depicted the number and position of renal arteries preoperatively in renal donors and excluded renal arterial or parenchymal disease. It accurately defined transplant arterial stenoses and demonstrated the status of the intrarenal circulation. No morbidity nor decreased renal function resulted. Digital video subtraction angiography has become the procedure of choice for these referrals at this institution.

Digital intravenous angiography: A new technique for obtaining ventriculograms following intravenous injection of iodinated contrast material

Digital intravenous angiography: A new technique for obtaining ventriculograms following intravenous injection of iodinated contrast material

Analysis of the pulmonary circulation using digital intravenous angiography: Correlation with indicator-dilution methods

Analysis of the pulmonary circulation using digital intravenous angiography: Correlation with indicator-dilution methods