Subtraktiangiografia

Subtraktiangiografia, sometimes spelled subtrakiangiografia in certain languages, is a radiologic imaging technique used to visualize small vascular networks in a targeted region through selective catheter-based contrast injection and fluoroscopic imaging. The term appears in a limited portion of radiology literature and its exact scope can vary by institution.

During the procedure, patient assessment includes checking kidney function and screening for iodinated contrast allergy. Vascular access is obtained (commonly through the femoral or radial artery), and a catheter is guided to the artery supplying the region of interest. Iodinated contrast is injected under continuous fluoroscopy, and digital subtraction angiography is used to enhance visualization of the vessels. Some protocols employ road-mapping or three-dimensional imaging to delineate feeding arteries and collateral branches. Local anesthesia with light sedation is typical.

Indications for subtraktiangiografia include evaluation of localized vascular malformations, mapping tumor perfusion, pre-embolization planning, and detailed assessment of complex vascular anatomy in the targeted region. It can provide dynamic flow information and high-resolution detail of small vessels, complementing CT or MR angiography when selective visualization is required for clinical decision-making.

Risks and limitations include exposure to ionizing radiation and iodinated contrast, potential contrast reactions or nephrotoxicity, and vascular injury at the access or catheter site. The procedure requires specialized equipment and expertise, and its use is generally focused on scenarios where precise selective angiography will influence management. Terminology and protocols may vary between centers, with some referring to similar practices as selective or super-selective angiography.