Study shows CT angiography can replace digital subtraction angiography

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CT angiography (CTA) is an effective noninvasive means to detect peripheral vascular disease, according to a study conducted by researchers at Charite Campus Benjamin Franklin in Berlin, Germany.

Peripheral vascular disease refers to diseases of blood vessels outside the heart and brain. It's often a narrowing of vessels that carry blood to the legs, arms, stomach or kidneys.

Fifty patients (34 men, 16 women) undergoing CTA were also referred for DSA (digital subtraction angiography) of the peripheral arteries. The images from both techniques were evaluated by two radiologists. According to the study, there were no significant differences in diagnostic quality observed between CTA and DSA. But the readers noted 70 and 72 segments of diagnostic images of pedal arteries, significantly more than the 57 shown on DSA.

The study showed that patient management decisions based on CTA were equal to those who had CTA and DSA in 49 of the 50 patients. Analysis of both CTA and DSA images required an average of 11.8 minutes for one reader and 9.9 minutes for the second reader, while CTA images required about 18 minutes for one reader and 18.7 for the other.

“CTA is an examination that is easily performed on almost every recent CT scanner,” said Bernhard Meyer, MD, lead author of the study. “In comparison to DSA, the physician needs no special knowledge (e.g. puncture technique or catheter handling), and they need no further assistance by a nurse to perform an angiography,” he said.

“The results show that there is a high agreement concerning the therapeutical decision based on either CTA or DSA. Therefore, in my eyes, DSA can be replaced by CTA alone,” said Meyer.

The full results of the study were presented on May 8, during the American Roentgen Ray Society Annual Meeting in Orlando, Fla.