Spinal Digital Subtraction Angiography Treatment Doctor in Delhi, India


Digital-Subtraction Angiography

With a minimal view of background tissues digital-subtraction angiography is the computer-assisted radiographic visualization of the carotids and cerebral vessels. In digital-subtraction angiography an image is taken before the injection of a contrast medium and after the injection of a contrast medium. The first picture has to be subtracted from the second, this is a process which helps in creating a highlight of the vessels. Digital-subtraction angiography is used to assess issues like aneurysm, AVM, fistula, occlusion, or stenosis. It is considered as the finest in assessment for carotid stenosis; But, it is less cost efficient and also it has although a small but a very significant risk of either a stroke or death because of the invasive nature of the test when it is compared with MRA or carotid ultrasound. The computer-assisted radiographic visualization of the carotids and cerebral vessels is also used in the operating room so that the integrity of anastomoses or cerebrovascular repairs can be examined.

With selective injections of dye into the intracranial arteries Digital subtraction angiography, has long been the finest for imaging intracranial aneurysms. Now since cerebral angiography is invasive, it’s procedural stroke risk range from 0.07% to 0.5%. This technology allows rotation of the virtual image in either direction, therefore it helps the neurosurgeons and endovascular practitioners to be able to evaluate aneurysm’s specific anatomic characteristics, which includes the neck width and the relationship of the aneurysm to the parent artery and branch vessels.

Digital subtraction angiography is considered necessary only if preoperative embolization is being considered, but it is an invasive diagnostic procedure with certain well known inherent risks. During Digital subtraction angiography the patient has to be layed in a supine, lateral, or prone position depending upon the location of the meningioma, frontal, tempororolandic, or occipital. If dural convexity’s attachment is wide, it becomes important for the head to be positioned in such a way that the meningioma has been located in the upper part of the operative field.

After a correct bone flap is achieved, then the surgeon might start cutting the dura all around the tumor and might start the dissection from the brain. But, the venous channels have to be kept intact and running close to the dura or inside in upper rolandic or in temporal locations might become a difficult challenge if attention was not paid to those veins during the preoperative workup.

Very rarely it happens that Convexity meningiomas impair venous drainage but the dissection of the veins adhering to the tumor is a second challenge. The key is to stay extrapially as much as possible and to dissect the tumor in the arachnoidal plane. Many arachnoidal adhesions might be cut without even coagulation. If it is too close to a vein even bipolar coagulation is dangerous. Separate veins that initially seemed impossible to spare meticulous dissection, never hurried, would successfully. It would keep the cortex intact in extrapial meningiomas but would also the integrity of the surrounding cortex in subpial tumors would also be preserved. To the tumor traction is applied to lift it after progressive separation from the brain. This enables to cut arachnoid adhesions and coagulate away progressively arteries as small branches that have been feeding the tumor, also the veins that are more fragile and more delicate to dissect. This technique has been recommended in all convexity locations, and not just in the rolandic area, as brain softening from venous infarct that might lead to disastrous consequences.

Happy Patients

Reshma Khanna



Dr. Vikas Gupta is a very good neurosurgeon. We are very satisfied with his stroke treatment for my mother. We were scared initially when our mom suffered from a brain stroke but Dr. Vikas assured us that with the help of surgery, she would be better. It’s been 3 months since her surgery and she is recovering well.

Aditya Singh



Dr. Vikas is one of the best neurosurgeons that I know of. I visited him for my father’s brain surgery and like always, Dr. Vikas didn’t disappoint. The surgery was successful and my father has almost recovered from it. Thank you doctor for your guidance and support.

Sanket Malik



My experience with Dr. Vikas Gupta was very good. He is kind, empathetic and helpful. He made sure we understood the problem which we were facing and was transparent and honest about everything. His diagnosis was accurate and treatment offered was cost effective


Spine and Brain Healers provides advanced medical care in the field of Adult neurosurgery,Paediatric Neurosurgery surgery, and Interventional Neurosurgery .

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