Carotid artery surgery based on digital subtraction angiography

This study shows that digital subtraction angiography provides the morphologic criteria necessary for surgical intervention in most patients with carotid atheroma. Digital subtraction angiography provides a safe means of studying patients, with an overall sensitivity of 96 percent and specificity of 86 percent. Radiopaque casts of the operative specimen have been used as the gold standard, providing a suitable means of comparing the findings on digital subtraction angiography with the operative findings. Failure to obtain good visualization of the vessels with biplanar views required conventional angiography to properly evaluate the vessels in 12 percent of patients. This technique represents a major advance in the study of carotid artery disease which may replace many of the current imaging techniques.