title: Conventional digital subtraction x-ray angiography versus magnetic resonance angiography in the evaluation of carotid disease: patient satisfaction and preferences.
abstract: OBJECTIVE
  To compare conventional digital subtraction x-ray angiography (DSA) and contrast-enhanced magnetic resonance angiography (MRA) of the carotid arteries in terms of patient satisfaction and preferences.
  
  
  METHODS
  One hundred and sixty-seven patients with symptomatic carotid artery disease, who underwent both DSA and MRA, were prospectively recruited in this study. Patients' perceptions of each method were assessed by the use of a questionnaire after each procedure. Main outcome measures were anxiety, pain, satisfaction rate and patient preferences.
  
  
  RESULTS
  DSA generated more anxiety and pain during the procedure, but the severity of these ill-effects was mild. Satisfaction rates for each method were similar. More patients were, however, willing to have a repeat MRA compared with DSA (67 versus 41%). The majority of patients (62%) preferred MRA over DSA (31%). The shorter MRA imaging time was found to be a significant factor in patients' acceptance of the technique. The main reasons cited by patients for their dislike of a particular procedure was noise and claustrophobia for MRA and invasiveness, pain and post-procedural bed rest for DSA.
  
  
  CONCLUSIONS
  MRA is the method that is preferred by the majority of patients, although the actual disutility of DSA may be small. Assuming equal diagnostic accuracy, our data supports replacement of DSA by MRA for routine carotid imaging.
authors.affiliation: Department of Radiology, Addenbrooke's Hospital and the University of Cambridge, Cambridge, UK.
authors.forename: J M
authors.initials: JM
authors.lastname: U-King-Im
authors.forename: R
authors.initials: R
authors.lastname: Trivedi
authors.forename: J
authors.initials: J
authors.lastname: Cross
authors.forename: N
authors.initials: N
authors.lastname: Higgins
authors.forename: M
authors.initials: M
authors.lastname: Graves
authors.forename: P
authors.initials: P
authors.lastname: Kirkpatrick
authors.forename: N
authors.initials: N
authors.lastname: Antoun
authors.forename: J H
authors.initials: JH
authors.lastname: Gillard
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015901:Angiography, Digital Subtraction / Q000379:methods / Q000523:psychology; D001007:Anxiety / Q000209:etiology; D016893:Carotid Stenosis / Q000175:diagnosis* / Q000523:psychology; D005260:Female; D006801:Humans; D018810:Magnetic Resonance Angiography / Q000379:methods / Q000523:psychology; D008297:Male; D008875:Middle Aged; D010146:Pain / Q000209:etiology; D017060:Patient Satisfaction; D011446:Prospective Studies; D011795:Surveys and Questionnaires