Fig. 1

Flowchart of the patient inclusion and exclusion, respectively. Conventional endovascular peripheral interventions (EPIs) with normal dose (EPI-ND) protocols were conducted with 370 patients between 11/2022 and 11/2023 and 62 patients using digital variance angiography (DVA) with low dose (DVA-LD) protocols between 11/2023 and 01/2024. The endpoints encompassed the evaluation of radiation dose using the dose area product (DAP) and image quality with regards to the contrast-to-noise ratio (CNR) in the ND groups compared to the LD groups. While the DAP evaluation included all EPIs using digital subtraction angiography (DSA) and digital unsubtracted angiography (DUA) acquisitions, CNR evaluation was exclusively conducted in DSA acquisitions due the possible comparability.