Digital subtraction angiography (DSA)

Synonyms
DSA, Digital subtraction angiography

Digital subtraction angiography (DSA) is a diagnostic procedure for visualizing blood vessels. Unlike conventional vascular imaging, DSA allows interfering image elements to be subtracted. In neurosurgery, digital subtraction angiography is used primarily to evaluate vascular conditions, such as Aneurysms or Arteriovenous malformations.

Complications

The most common complication is a groin hematoma, which occurs in approximately 4 % of patients[^2]. The prevalence of a permanent neurological deficit following digital subtraction angiography, for example due to stroke, is approximately 0.1–0.3 %[^1] [^2]. Serious complications resulting in death are rare, occurring at a frequency of approximately 0.06 %[^2].

Imaging

Digital subtraction angiography
Digital subtraction angiography via the right internal carotid artery. This represents part of a cerebral panangiogram, as visualization of the external carotid artery and the vertebral artery is also required.
DSA of the posterior circulation
Visualization of an unremarkable posterior circulation using digital subtraction angiography.

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