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Digital Subtraction Angiography Technique

  Digital Subtraction Angiography Technique is the technique which is provide the clear image of inner surface of blood vessels also called lumen. 

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Digital Subtraction Angiography Technique
Pic Credit : American Journal Of Neuroradiology

Digital Subtraction Angiography Technique

Digital Subtraction Angiography (DSA) is a fluoroscopic technique that uses complex X-rays machine to provide clear images of the inner surface of blood vessels also called lumen. this technique provide clear image of arteries, veins as well as the four chamber of heart. this technique i widely used in interventional radiology since it help to eliminate radiopaque structures like bone and provide and accurate images of blood vessels.

Why Digital Subtraction Angiography is used?

Digital Subtraction Angiography is used to diagnose a variety of disease related to the blood vessels a person may result of blockage or narrowing in the inner section of the arteries and vein moreover, the procedure can also be used to diagnose other condition such as brain aneurysm, bleeding vessels, unusual link of a arteries and vein as well as analyse the blood vessels of a tumor. 

Digital Subtraction Angiography Procedure

The procedure is performed by using a catheter a small flexible narrow tube which is inserted into an artery in the leg and allowed to flow to up to the blood vessels in the brain. then a contrast media ( typically a high density clear liquid ) is injected into the catheter to allow the clear picture of blood vessels in legs heart or other organ. a picture is taken before and after contrast dye i injected then the first image is subtracted from the second image to highlight the blood vessels. this is why the method is called Digital Subtraction Angiography

Before Conducting a digital subtraction angiography the doctor will examine the patient on a number of factors and conditions some evaluation parameters include, thought are limited too

  • Any atherosclerotic disease such as myocardial infection.
  • Diabetes
  • Renal Functionality 
  • Ongoing medicines
  • Allergies 
  • Previous surgeries  
  • Report of past angiogram, if any
  • Reports of vascular imaging studies relevant to the procedure.
  • Any other Health condition that could potentially cause complication.

Once the pre- evaluation is done correctly, the patient is asked to lie down on an angiography table and is given local anaesthesia.

Once done, a small incision is done in the leg of the patient to insert the catheter into the artery in the leg. once placed, a contrast medium a dye is injected into the catheter to produce the interfering overlapping tissues. before the contrast media is injected into the catheter mask image of the area concerned is taken which is typically shows results like a normal x ray image once the contrast media is successfully inserted, contrast images are taken via complex x-ray machine during the time the contrast media is flowing into the artery these images are then sorted and worked upon digitally by subtracting the on contrast ( mask images ) pixel by pixel from the contrast images to show filled vessels. these images can be viewed in real time since they displayed continuously on the monitor, while the examination is in progress.

Once the procedure is done completely, hemostasis is done to the incision site post- operative care is advised by the doctor, per case basis.

Complication of a Digital Subtraction Angiography 

A DSA is relatively a safe procedure with rare complications such as,

Drainage or bleeding from the site of the incision.

Formation of a pseudoaneurysm at the site of incision.

Harmful effects of a contrast medium on other organ such as kidney.

Hypersensitivity or allergy to the contrast medium. 

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