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DIGITAL SUBTRACTION ANGIOGRAPHY
 
We commissioned our new digital subtraction angiography suite in Timberland Medical Centre in November 2007. It was officially declared open by YB Dato' Yong Khoon Seng during the open day held on 18 November 2007. The system is capable of both cardiac and vascular applications.

The first examination was a cerebral angiogram performed in a 23 year old man with a left occipital parenchymal bleed. (fig1).

Digital subtraction angiography was performed via a right femoral puncture. Vertebral angiograms showed a venous anomaly inferior to the haematoma. (Fig.2).

Rotational subtraction angiography was performed to clarify the relationship of the anomaly to the surrounding vessels. (Fig.3).
 
DIGITAL SUBTRACTION ANGIOGRAPHY photo   DIGITAL SUBTRACTION ANGIOGRAPHY photo
Fig 1. Plain CT showing left occipital haematoma.   Fig.2 Left vertebral angiogram showing a venous anomaly associated with the left posterior artery circulation
 
DIGITAL SUBTRACTION ANGIOGRAPHY photo
Fig. 3 Selected rotational subtraction images
 
A provisional diagnosis of a venous angioma was made.

The second examination was a right lower limb angiogram performed on a 78 year old woman with gangrene of her right 3rd toe. She had a previous left below knee amputation. Angiograms showed multiple stenoses in the right popliteal and proximal posterior tibial arteries. (Fig4)

DIGITAL SUBTRACTION ANGIOGRAPHY photo
Fig. 4 Popliteal angiograms showing multiple moderate stenoses in the popliteal artery.
 
The distal posterior tibial and peroneal arteries were markedly diminished in caliber and showed delayed flow. The anterior tibial artery was occluded. ( Fig. 5)

DIGITAL SUBTRACTION ANGIOGRAPHY photo
Fig.5 Angiograms below knee and above ankle level showing small right posterior tibial and peroneal arteries. The right anterior tibial artery is occluded.
 
Our angiography system is equipped with a stepping digital subtraction option which allows for multiple acqusitions with automated table movement ( up to 6 stations). This allows sufficient coverage of a single lower limb with a single contrast injection.

The angiography suite is also equipped with a hemodynamics monitoring system to complement coronary angiography.

With the arrival of digital subtraction angiography, the dianostic imaging department is able to provide a wider range of imaging services to the patients of Timberland Medical Centre.
 
Prepared by
Dr. Vincent Chen Boon Hean
Consultant Radiologist.
 
Timberland Medical Centre @ 2015 Lembaga Iklan Ubat no : KKLIU 2353/2015