Stepped digital angiography with dynamic subtraction: a new diagnostic approach to peripheral angiography

On the basis of our first experiences, a purchasable angiography system for peripheral angiography with dynamic subtraction and stepping (DPSA) has been developed. This study reports on the optimization of this technique and the first clinical results in comparison with conventional screen-film angiography and digital subtraction angiography (DSA) in single steps. For each method, 25 angiograms were interpreted to compare the image quality, the radiation exposure, the contrast medium and the film consumption as well as the examination time. Image quality proved to be comparable in DPSA and DSA in single steps. Both techniques showed better results than conventional angiography, especially in the region of the knee and lower leg. Using DPSA radiation exposure dropped by a factor of 2 compared with conventional angiography and by a factor of 6 compared with DSA in single steps. Consumption of contrast medium can also be reduced in comparison with the other two methods. Film consumption is incomparably higher in conventional screen-film angiography. With DPSA the examination time can be reduced by half on average compared with the other two methods. DPSA may come to be the standard in peripheral angiography.Correspondence to: U. Fink