Routine use of limited abdominal aortography with digital subtraction carotid and cerebral angiography.

Abstract

We sought to evaluate the usefulness of limited abdominal aortography performed in conjunction with intra-arterial carotid digital subtraction arteriography (DSA) for identification of clinically unsuspected lesions. In a prospective study performed in the Department of Radiology after preliminary carotid duplex imaging, 401 consecutive bilateral carotid intra-arterial DSAs were performed for evaluation of cerebrovascular disease from June 1988 to November 1992. We detected unilateral renal artery stenosis in 24 patients (6%), bilateral renal artery stenosis in 5, renal cell carcinoma in 1, renal artery aneurysm in 1, abdominal aortic aneurysm in 23 (5.7%), aortic ectasia in 16, and iliac aneurysm in 2. When single-plane digital abdominal aortography is performed in conjunction with carotid intra-arterial DSA, significant pathological lesions can be detected with little increase in morbidity and only modest increase in time and cost.