Digital Subtraction Angiography and Interventional Therapy for Cerebrovascular Diseases
What is Digital Subtraction Angiography (DSA)?
Digital Subtraction Angiography is a highly effective diagnostic procedure used to detect abnormalities in the blood vessels of the brain and neck. During this procedure, a catheter is inserted through the femoral artery and guided to the arteries supplying blood to the brain. A contrast dye is then injected, allowing detailed imaging of the cerebral and cervical vasculature. This method enables physicians to identify the presence and severity of arterial narrowing or blockage, determine whether collateral circulation has developed, and diagnose conditions such as intracranial aneurysms and vascular malformations. DSA remains the gold standard for diagnosing cerebrovascular diseases and cannot be replaced by other imaging techniques.Who Should Undergo Cerebral Angiography?
Patients suspected of having cerebral artery stenosis are typically recommended for this diagnostic test. This includes individuals experiencing transient ischemic attacks (TIA), watershed infarction, large cerebral infarcts, strokes in young adults, and cerebral steal syndrome. Additionally, patients with non-hypertensive intracerebral hemorrhage or subarachnoid hemorrhage should undergo DSA to identify the underlying cause of bleeding.What Are the Possible Complications of Cerebral Angiography?
Cerebral angiography is now a well-established and safe diagnostic technique. In our department, we have performed nearly a thousand procedures over many years, with a complication rate of approximately 0.5%. Complications are more commonly observed in elderly patients or those with severe vascular calcification, where plaque dislodgement may lead to ischemic stroke. However, such events remain rare and are carefully managed by experienced medical teams.Understanding Interventional Therapy for Cerebrovascular Diseases
Interventional therapy refers to a minimally invasive treatment approach that uses catheter-based techniques to diagnose and treat vascular abnormalities in the brain and neck region. Compared to traditional open surgery, this method offers several advantages, including no incisions, reduced trauma, simpler procedures, and reliable clinical outcomes.What Conditions Can Be Treated with Interventional Therapy?
Interventional techniques are widely used in the management of both ischemic and hemorrhagic cerebrovascular diseases. These include:1) Brain arteriovenous malformations (AVMs) and fistulas
2) Spinal arteriovenous malformations
3) Dural (spinal or cerebral) arteriovenous fistulas
4) Carotid-cavernous fistulas
5) Intracranial aneurysms
6) Acute cerebral infarction
7) Cerebral vasospasm
8) Cerebrovascular stenosis
9) Preoperative embolization of hypervascular tumors in the neck region
Treatment options include stent placement for ischemic diseases, intra-arterial thrombolysis, coiling or embolization for aneurysms and vascular malformations. These procedures are performed with precision and minimal risk, offering patients a safer and faster recovery option compared to conventional surgical approaches.