A comparison of bolus chasing and static digital subtraction arteriographyin peripheral vascular disease

The purpose of this study was to compare the techniques of bolus chasing an giography (BCA) and digital subtraction angiography (DSA). 75 patients with symptomatic atherosclerotic peripheral vascular disease were randomly assi gned to have their lower limbs examined by BCA or DSA. Dose-area product (D AP), time of examination and dose of contrast medium were measured. Staff d oses were measured with personal electronic dosemeters. Image quality was a ssessed from the laser printed images. DSA produced better images of vessel s below the inguinal ligament, particularly the crural vessels (1/76 vs 17/ 74 non-diagnostic examinations, p < 0.00001) but at a higher DAP (median 53 .8 Cy cm(2) vs 18.9 Gy cm(2), p < 0.01). Contrast medium dose was higher wi th BCA (29.8 gI(2) vs 25.3 gI(2), p < 0.01). Staff doses per unit patient d ose were 2.3-3.3 times higher with BCA than DSA. Because of the poor lone-t erm prognosis of patients with peripheral vascular disease, the improved im age quality obtained by DSA justifies the increased radiation dose.