Digital subtraction angiography in cerebrovascular disease: current practice and perspectives on diagnosis, acute treatment and prognosis

Shirin Shaban; Bella Huasen; Abilash Haridas; Murray Killingsworth; John Worthington; Pascal Jabbour; Sonu Menachem Maimonides Bhaskar

doi:10.1007/s13760-021-01805-z

Digital subtraction angiography in cerebrovascular disease: current practice and perspectives on diagnosis, acute treatment and prognosis

Acta Neurol Belg. 2022 Jun;122(3):763-780. doi: 10.1007/s13760-021-01805-z. Epub 2021 Sep 22.

Authors

Shirin Shaban^{1

2}, Bella Huasen³, Abilash Haridas^{1

4}, Murray Killingsworth^{1

2

5

6}, John Worthington^{1

7}, Pascal Jabbour⁸, Sonu Menachem Maimonides Bhaskar^{9

10

11

12

13}

Affiliations

¹ Neurovascular Imaging Laboratory, Clinical Sciences Stream, Ingham Institute for Applied Medical Research, Sydney, Australia.
² University of New South Wales (UNSW), South Western Sydney Clinical School, Liverpool, NSW, Australia.
³ Department of Interventional Radiology, Lancashire University Teaching Hospitals, Lancashire Care NHS Foundation Trust, Preston, UK.
⁴ Baycare Medical Group, Pediatric Neurosurgery, Cerebrovascular and Skull Base Neurosurgery, St Joseph's Hospital, Tampa, FL, USA.
⁵ NSW Brain Clot Bank, NSW Health Pathology, Sydney, Australia.
⁶ Department of Anatomical Pathology, Correlative Microscopy Facility, NSW Health Pathology, Sydney, Australia.
⁷ RPA Comprehensive Stroke Service and Department of Neurology, Royal Prince Alfred Hospital, Camperdown, Sydney, Australia.
⁸ Division of Neurovascular Surgery and Endovascular Neurosurgery, Thomas Jefferson University and Jefferson Hospital for Neuroscience, Philadelphia, PA, USA.
⁹ Neurovascular Imaging Laboratory, Clinical Sciences Stream, Ingham Institute for Applied Medical Research, Sydney, Australia. Sonu.Bhaskar@reprogramglobal.org.
¹⁰ University of New South Wales (UNSW), South Western Sydney Clinical School, Liverpool, NSW, Australia. Sonu.Bhaskar@reprogramglobal.org.
¹¹ NSW Brain Clot Bank, NSW Health Pathology, Sydney, Australia. Sonu.Bhaskar@reprogramglobal.org.
¹² Department of Neurology and Neurophysiology, Liverpool Hospital and South Western Sydney Local Health District, Sydney, Australia. Sonu.Bhaskar@reprogramglobal.org.
¹³ Department of Neurology and Neurophysiology, Clinical Sciences Building, Liverpool Hospital, Elizabeth St, Liverpool, NSW, 2170, Australia. Sonu.Bhaskar@reprogramglobal.org.

PMID: 34553337
DOI: 10.1007/s13760-021-01805-z

Abstract

Digital Subtraction Angiography (DSA) is the gold-standard imaging modality in acute cerebrovascular diagnosis. The role of DSA has become increasingly prominent since the incorporation of endovascular therapy in standards of care for acute ischemic stroke. It is used in the assessment of cerebral vessel patency; however, the therapeutic role of DSA from a prognostic standpoint merits further investigation. The current paper provides an update on current practice on diagnostic, therapeutic and prognostic use of DSA in acute cerebrovascular diseases and various indications and perspectives that may apply, or limit its use, in ongoing surveillance or prognosis. Pre-clinical and clinical studies on the aspects, including but not limited to the morphology of cerebrovasculature in acute ischaemic stroke, are required to delineate and inform its prognostic role.

Keywords: Acute ischaemic stroke; Cerebrovascular angiography; Cerebrovascular disease; Digital subtraction angiography (DSA); Interventional neurology; Prognosis; Reperfusion.

MeSH terms

Angiography, Digital Subtraction / methods
Brain Ischemia*
Cerebral Angiography / methods
Cerebrovascular Disorders* / diagnostic imaging
Cerebrovascular Disorders* / therapy
Humans
Ischemic Stroke*
Prognosis
Stroke*

Grants and funding

NSW Brain Clot Bank (2019-2022)/NSW Ministry of Health