[Rotational digital subtraction angiography of carotid bifurcation stenosis]

Rofo. 1999 Oct;171(4):283-9. doi: 10.1055/s-1999-11093.
[Article in German]


Purpose: A prospective study was designed to evaluate, whether multiplanar imaging with rotational digital subtraction angiography (R-DSA) could improve assessment of carotid artery bifurcation stenosis.

Patients and methods: 45 patients with suspected stenosis of the ICA were examined with DSA in standard projections (0 degree-(45 degrees)-90 degrees) and additional R-DSA of each ICA from 0-90 degrees in 10 degrees steps. We compared imaging quality and degree of stenosis as well as exposure of the patients to radiation and contrast media.

Results: 79/82 R-DSA (96%) were suitable for evaluation of stenosis, 58/82 (70%) matched the quality standard of single projection DSA. Specificity and sensitivity of the R-DSA to diagnose high grade ACI stenosis were 100% and 94%, respectively. 7/79 R-DSA revealed a higher and 3/79 a lower degree of stenosis than the corresponding DSA. Regarding the degree of stenosis there was no significant difference between the two modalities (p > 0.05), but R-DSA detected 4 stenoses greater than 60% that were estimated to be lower than 60% by DSA. Radiation dose for R-DSA was equivalent to one DSA run (170 cGycm2). The average amount of contrast media (25 ml) was slightly higher than for 2-3 single-projection DSA (19.8 ml).

Conclusions: R-DSA provides high quality imaging of the carotid bifurcation with multiplanar projections facilitating exact grading of vessel stenosis. The number of cases (n = 2) is to small to judge the value of R-DSA as to (tandem-) stenosis of the distal ICA. Still, diagnostic value and low radiation exposure justify the use of R-DSA as additional series to standard protocols.

Publication types

  • Comparative Study

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Angiography, Digital Subtraction / methods*
  • Carotid Artery, Common / diagnostic imaging*
  • Carotid Stenosis / diagnostic imaging*
  • Data Interpretation, Statistical
  • Female
  • Humans
  • Male
  • Middle Aged
  • Prospective Studies
  • Sensitivity and Specificity