One such technique is the Digital Subtraction Angiography (DSA), that is more commonly known as Cerebral Angiography. It is a diagnostic procedure that is performed to find out any blockages in the blood vessels of head and neck. It gives a detailed idea to the doctor regarding exact site and extent of blockage. It makes use of x-rays and contrast material to create pictures of blood vessels in the brain.
DSA is required in the following cases:
It also helps the doctors in diagnosing the cause of following symptoms so that required treatment line can be accurately suggested:
The intra-arterial DSA involves lesser use of contrast dye and smaller catheters and is thus more preferred over conventional subtraction technique.
Before the patient is taken in for procedure, some blood investigations are done to check the functioning of kidneys and also blood clots. On the day of procedure, patient is asked to come empty bladder. Procedure begins by giving sedation through IV in case of adults and general anesthesia in case of children.
An area of the groin is shaved and sterilized for inserting catheter. Now the procedure begins by inserting the catheter and heading it to the patient's carotid artery in the neck, through the blood vessels. This is done with the help of x-ray guidance.
A non-ionic contrast dye is then injected through the catheter. The interventional radiologist uses a special machine called power injector (attached to the catheter) to make sure that the dye is passed precisely at the right volume and rate. As soon as the dye reaches blood vessels that are to be examined, various sets of x -rays are taken .
Once the procedure gets completed, the catheter is carefully removed and pressure is applied to avoid any bleeding from the site. Though sutures are not required, the skin opening in groin area is covered with dressing to avoid any infection at the site of catheter insertion.
The procedure ideally gets completed in 1 to 2 hours.
Patient might feel a slight pricking sensation when needle for IV is inserted but once the sedative has been given, he/she feels relaxed and sleepy. There are no serious discomforts associated with this procedure. The most important part is to keep lying static during the procedure, particularly when the x-ray images are being taken.
Patient may remain in recovery area for few hours after the procedure for observation and monitoring.
During post - op stay in the hospital, patient is given special instructions like keeping the legs straight for few hours to avoid strain and bleeding from the groin area where catheter was inserted. In order to relieve swelling and pain, cold compression may be applied at the site where catheter was inserted.
There are no any specific dietary instructions in this procedure. Patient an start having normal diet immediately after the procedure.
Patient can resume routine activities after a rest of 12 to 24 hours. But make sure you do not get involved in any activity that will put pressure on the site of catheter insertion for few days.
The x-ray images taken during the procedure will be analyzed by radiologist and your treating doctor. Based on the findings of report, further treatment line will be suggested.
Patient would require a follow up visit, in case any other investigations or intervention is needed. This visit is sometimes essential for discussing any complicated findings in the report.
It may also help in assessing the effect of treatment that the patient undergoes after DSA or any abnormal changes over a period of time.
Benefits of DSA include :-
Risks involved in DSA :-
The treating doctor needs to be immediately contacted in case of - numbness or weakness in the face, arms and leg muscles, vision impairment, difficulty in speaking and breathing, chest pain and dizziness.