A preliminary investigation of the feasibility and practical clinical utility of combined temporal energy (hybrid) subtraction for intravenous digital subtraction angiography (DSA) was performed in 19 selected patients. Studies of carotid, aortic arch, pulmonary, and aortorenal vessels were obtained. Soft-tissue misregistration artifacts were effectively removed with hybrid subtraction. Image integration was used to produce a signal-to-noise ratio equivalent to that of single frame temporal subtraction. Diagnostic improvements were produced in 20% of the examinations. Hybrid subtraction techniques resulted in an average increase of incident radiation dose to the skin of 15%.