Both Digital Subtraction Angiography (DSA) and Magnetic Resonance Angiogram (MRA) have

their own advantages and disadvantages in establishing a diagnosis of Transient Ischemic

Attack (TIA).

DSA is an invasive radiological procedure that involves injecting a contrast agent into an artery
and using X-ray technology to visualize blood flow through the blood vessels. It provides very
detailed images of the blood vessels and is considered the "gold standard" for evaluating blood
flow and determining the location of any blockages or stenosis. However, it is an invasive
procedure and has a small risk of complications such as allergic reactions, kidney damage, and
bleeding.

MRA, on the other hand, is a non-invasive imaging technique that uses a strong magnetic field,
radio waves, and computer algorithms to produce detailed images of the blood vessels. It is a
safe and painless alternative to DSA and does not involve any exposure to ionizing radiation.
However, MRA images can be less detailed than DSA and may not be able to visualize all blood
vessels, particularly smaller ones, as accurately as DSA.

In the diagnosis of TIA, both DSA and MRA can be useful in evaluating the blood vessels and
determining the cause of symptoms. However, the choice between the two will depend on the
individual patient's situation and the specifics of the case, as well as the expertise and
preferences of the medical team. In some cases, a combination of both techniques
may be used to get a complete and accurate picture of the blood vessels.

Ultimately, the decision regarding which imaging modality to use should be made by a
healthcare professional in consultation with the patient, taking into account the patient's
specific needs and medical history.

References:
1. Balicki M, Rylski B, Kwiatkowski J, et al. Diagnostic accuracy of magnetic resonance
angiography compared with digital subtraction angiography in patients with symptomatic
peripheral arterial disease: a meta-analysis. J Vasc Surg. 2012 May;55(5):1331-8.
2. De Havenon A, Paul J, Demchuk AM, et al. Magnetic resonance angiography versus
digital subtraction angiography in stroke: a meta-analysis. Lancet Neurol. 2006
Mar;5(3):235-42.