Digitally subtracted angiography of the extremities in step-translation technique

Purpose: To evaluate, how routine application of i.a. DSA with the step-translation technique using a single contrast bolus can effectively reduce radiation exposure and the amount of contrast media in comparison to standard peripheral DSA. Method/Materials: 100 patients with peripheral arterial occlusive disease were assessed with steptranslation DSA, 100 with standard DSA using the same equipment. Imaging quality was rated two observers, judgement by consensus. Comparison of the technical data (radiation dose, contrast media) was based on pairs of patients with similar constellations of stenoses to reduce selection bias. Results: Step-translation DSA was of high imaging quality from the iliac vessels to the popliteal artery. In the distal leg, imaging was often impaired by effects like unilaterally delayed contrast flow due to high grade stenosis or motion artifacts. 53% of the step translation DSA required 1 or 2, 29% more than two additional DSA runs. Including the additional runs, the average radiation exposure and the amount of contrast media (2434 cGycm2/128 ml) were comparable to those of standard DSA (2461 cGycm2/144 ml). Conclusions: Step-translation DSA provides high quality images. In routine application realization of the advantages over standard DSA such as reduction of examination times, radiation exposure and amounts of contrast media may be impaired by poorly collateralized stenoses or motion artifacts demanding additional series. (orig.)