Intravenous digital subtraction angiography in the diagnosis and management of acute aortic dissection

Eleven patients presenting with the clinical diagnosis of suspectedaortic dissection underwent intravenous digital subtractionaortography. In nine patients digital subtraction angiography(DSA) was performed as the investigation of first choice. Infive of these the diagnosis was confirmed with this techniquealone and surgical repair was undertaken without further investigation.Direct cine aortography was also undertaken in the other fourpatients and confirmed the DSA findings, demonstrating aorticdissection in one case and no dissection in three others. In two of the eleven patients, direct cine aortography was performedas the initial investigation. The results of subsequent digitalaortography concurred in both cases, aortic dissection beingdemonstrated in one patient. In two cases, despite normal cineand digital aortography, aortic dissection was confirmed bycomputed tomography. We have found DSA to be a valuable technique for diagnosingaortic dissection, with no false positive or false negativefindings when compared to direct cine aortography. Since itis a less traumatic procedure than direct aortography it shouldbe the investigation of choice if computed tomography is notimmediately available.