Forty-four patients with Takayasu's arteritis were explored by digital intravenous angiography either for diagnostic purposes and pre-therapeutic assessment (n = 29) or immediately after surgery (n = 15). There were 36 women, 6 men and 2 children; mean age was 31 years. The contrast medium (mean volume 140 ml) was injected into central (74%) or peripheral (26%) veins. No other angiographic exploration was contemplated in 24 patients selected for medical treatment. Among 15 patients destined to surgery or percutaneous angioplasty, 13 were operated upon without further angiography and 2 underwent arteriography since the distal vascular bed beyond the major lesions could not be evaluated adequately. Data obtained from post-operative evaluation (n = 15) were satisfactory, with 1 failure in this group. Digital intravenous angiography seems to be reliable enough to be used as first examination in patients with suspected Takayasu's arteritis. The procedure is well tolerated and can be repeated for optimum determination of the operation date. Arteriography can now be reserved to those rare cases where digital angiography has failed; it can then be limited to the study of a specific territory, the site of puncture being located by digital angiography.

Forty-four patients with Takayasu's disease were investigated by digitised intravenous angiography (DIVA) during a diagnostic and pretherapeutic work up (N = 29) or at surgery (N = 15); the aim of this retrospective study was to assess the role of DIVA in the investigation of this condition. The patients were 36 women, 6 men and 2 children; the average age was 31 years. The intravenous injections were performed in a central vein in 74% and in a peripheral vein in 26% of patients; the average amount of contrast medium injected was 140 ml per investigation (32 g of iodine %). Depending on the site of the lesions, the distribution of the 43 successfully investigated patients was as follows: Type I: 13 (20%), Type II: 6 (14%), Type III: 12 (28%), Type IV: 12 (28%). In the group of patients managed medically (N = 14) no other angiographic investigations were considered. In the group with an indication for surgery or percutaneous angioplasty (N = 15), the procedure was carried out without further angiography in 13 cases; in 2 patients the imaging of the distral vessels was inadequate and complementary angiography was required. All postoperative controls (N = 15) but one were satisfactory. These results show that DIVA is sufficiently reliable for it to be considered as an investigation of first intent in patients with suspected Takayasu's disease. The investigation is well tolerated and can be repeated when necessary to determine the optimal time for surgery. Arterial angiography should seem only to be indicated when the venous approach has failed, which was rare in this series.

Forty-four patients with Takayasu's disease were investigated by digitised intravenous angiography (DIVA) during a diagnostic and pretherapeutic work up (N = 29) or at surgery (N = 15); the aim of this retrospective study was to assess the role of DIVA in the investigation of this condition. The patients were 36 women, 6 men and 2 children; the average age was 31 years. The intravenous injections were performed in a central vein in 74% and in a peripheral vein in 26% of patients; the average amount of contrast medium injected was 140 ml per investigation (32 g of iodine %). Depending on the site of the lesions, the distribution of the 43 successfully investigated patients was as follows: Type I: 13 (20%), Type II: 6 (14%), Type III: 12 (28%), Type IV: 12 (28%). In the group of patients managed medically (N = 14) no other angiographic investigations were considered. In the group with an indication for surgery or percutaneous angioplasty (N = 15), the procedure was carried out without further angiography in 13 cases; in 2 patients the imaging of the distral vessels was inadequate and complementary angiography was required. All postoperative controls (N = 15) but one were satisfactory. These results show that DIVA is sufficiently reliable for it to be considered as an investigation of first intent in patients with suspected Takayasu's disease. The investigation is well tolerated and can be repeated when necessary to determine the optimal time for surgery. Arterial angiography should seem only to be indicated when the venous approach has failed, which was rare in this series.

Numeric angiography is an examination of choice for studying the thoraco-abdominal aorta, whatever the underlying pathological condition, and is often the only angiographic investigation useful and necessary for deciding on therapy in cases of aneurysm. In contrast, results are unsuccessful in approximately 15% of cases when neck vessels are studied. Significant lesions nearly always produce sufficient information for the decision as to therapy to be made. Vascular surgery follow up is an excellent indication for numeric angiography, whatever the surgical technique used or the anatomic site involved. Reliable data can be obtained from pulmonary vessels by the use of this method in patients with pulmonary embolism, arteriovenous malformations, and abnormal venous return.

The authors report their experience of 1 000 examinations using digital subtraction angiography. The technique is particularly well suited to the study of the thoraco-abdominal aorta and its main branches. It is about 80% reliable for the exploration of cervico-encephalic vessels and somewhat less reliable for the vertebro-basilar territory. It is usually convenient for the study of the renal arteries: investigations for reno-vascular hypertension can now be carried out in one session beginning with angiography and ending with urography. Digital subtraction angiography is also very useful in the assessment of vascular surgery, whatever the area involved or the type of operation, and for the study of pulmonary vessels, notably when looking for pulmonary emboli. Digital subtraction arteriography is undoubtedly superior to conventional arteriography. Its impact remains to be determined, but is avoids the drawbacks of the venous route. Its present limitations are of a technical nature: the intensifying screen is too small so that the examination must proceed by segments, hence the need for repeated doses of contrast medium the dangers of which must be borne in mind when digital subtraction angiography is contemplated. On the other hand, this technique has obvious economical advantages: examinations can be performed in out-patients and substantial savings can be made on the number of films.