Digital subtraction arteriography. A new method for evaluation of extracranial occlusive disease.

Digital subtraction arteriography (DSA) allows visualization of both the intracranial and extracranial vasculature following an intravenous injection of contrast medium. One hundred consecutive patients were evaluated using this modality. In 32, DSA was compared with conventional arteriography. The degree of internal carotid artery stenosis and/or occlusion shown by DSA was confirmed by conventional arteriography in 27 cases (84%). Abnormalities of the extracranial vasculature was demonstrated by DSA in 60% of patients with suspected cerebrovascular disease. Digital subtraction arteriography demonstrated significant stenosis or occlusion of the carotid arteries in 30% of patients in whom Doppler and radionuclide studies were normal. Digital subtraction arteriography is useful in evaluation of the extracranial vasculature in a variety of clinical conditions. In some instances it serves as a substitute for conventional arteriography. However, its exact place in evaluation of extracranial vasculature disease remains to be defined.