Intravenous digital subtraction angiography in the management of peripheral vascular disease.

All patients undergoing peripheral injection intravenous digital subtraction angiography (ivDSA) for peripheral vascular disease during 1987 have been reviewed (140 patients). The radiological distribution of disease was aorto-iliac occlusive (AI) 36 (23%), femoropopliteal (FP) 68 (44%), mixed AI/FP 36 (23%). Clinical diagnosis was correct for AI disease in 92%, for FP disease in 65% and for mixed AI/FP disease in 47%. ivDSA was the only investigation required for management in 111 of all 140 patients (79%), and in 33 of the 36 patients with AI disease (92%), but was less accurate in defining femoropopliteal disease, 22 patients (32%) requiring additional arteriography. Conventional arteriography was performed in 200 patients in 1982 compared with 100 in 1987. ivDSA is particularly suitable for the investigation of AI disease, a condition which is accurately detected by clinical examination, with a reduction in morbidity and bed occupancy.