Initial Operating Room Experience with Digital Variance Angiography in Carbon Dioxide-Assisted Lower Limb Interventions: A Pilot Study

Purpose In retrospective clinical studies digital variance angiography (DVA) provided higher contrast-to-noise ratio and better image quality than digital subtraction angiography (DSA). Our aim was to verify the clinical usefulness and benefits of DVA in carbon dioxide (CO 2 )-assisted lower limb interventions. Materials and Methods A workstation running the DVA software was integrated into a Siemens Artis Zee with Pure angiography system, and this new image processing technology was used in four patients (3 male, 1 female, age: 76.2 ± 4.2 years) with peripheral artery disease (PAD, Rutherford 2–3) and impaired renal function (average eGFR 25.5 ± 11.2 ml/min/1.73 m 2 ). The DSA and DVA images of 46 CO 2 -assisted runs were visually evaluated by five experts in single-image evaluation using a 5-grade Likert scale and in paired comparisons. Results DVA images received significantly higher score (3.84 ± 0.10) than DSA images (3.31 ± 0.10, p