DSA or Digital Subtraction Angiography is an examination that provides images of the inner surface of blood vessels, including arteries, veins and the atrium of the heart. The images produced by DSA are obtained using complex computer-assisted X-ray machines. DSA visualizes blood vessels, with radiopaque structures such as bone removed or reduced, digitally from the image. This leads to the possibility of accurate depiction of blood vessels. DSA is a technique used with the following objectives:
- Diagnostics, where DSA aims to detect blood vessel abnormalities, tumor vascularization, and others. Before carrying out DSA for diagnostic purposes, the patient needs to make preparations, namely fasting for 4 hours, checking Hb and leukocytes, liver and kidney function. For diabetes mellitus patients, it is best to stop using the drug the day before the DSA procedure.
- Therapeutic, DSA here aims to treat abnormalities in blood vessels, by inserting drugs, devices or implants into the targeted blood vessels. DSA also aims to be a complementary therapy before undergoing surgery.
The DSA examination technique is generally used to diagnose various blood vessel diseases. DSA is an endovascular procedure that is the standard for all blood vessel procedures in the brain. Usually DSA is performed as a continuation of CT-Scan or MRI. with a procedure using a fine tube inserted through a blood vessel in the groin. During the DSA process, the patient is only given local anesthesia so that the patient is conscious during this procedure. DSA is an action that only takes approximately 40 minutes.
The side effects of DSA are displacement of the vessels with the catheter, or tearing of the blood vessels. These side effects are much smaller compared to the procedure, which had to be undertaken before this technology was developed. DSA is an examination that uses a radiological angiography aircraft, so it must be carried out by a radiology specialist who understands and fully understands how radiation protection is for patient safety. An angiography machine uses x-rays, in real time or continuously, to monitor the blood vessels being examined after contrast is injected. So that the blood vessels are visible from the arteries, tissue, to the venous phase. The aim of brain DSA is to see blood vessel abnormalities in the brain such as aneurysms (widening of blood vessels), AVM (Artery Venous Malformation), stenosis (narrowing), AVF (Artery Venous Fistule) and tumors that contain many blood vessels (meningioma).
Article written by dr. Erwin Joe, Sp.N-FINA (Neurology / Neurology Specialist at EMC Pulomas Hospital).