[Transfemoral pelvic vein angiography with CO2: experiences with pressure- and volume-controlled injections]

To evaluate the efficacy of CO2 in aortobifemoral DSA with a pressure- and volume-controlled injector.

In an intraindividual prospective study, 42 patients with arterial occlusive disease underwent stepwise aortobifemoral DSA with CO2 and with iopromid 300.

With Co2, diagnostic images were obtained in 74% of the iliac, 98% of the femoral, 89% of the popliteal arteries, but in only 36% of the arteries of the lower leg. 73% of the stenoses were correctly identified. With therapeutic relevance 8% of the stenoses were overestimated. The length of 1 of 53 occlusions was overestimated and 3 occlusions were simulated. No stenoses or occlusion was missed. There were no severe side-effects. The injector proved to be safe and easy to handle. Fragmentation of the CO2 bolus could be compensated by postprocessing with a minimum opacification summation mode.

With the equipment used, CO2 was a safe alternative to iodinated CM in routine stepwise aortobifemoral DSA of the iliac, femoral, and popliteal arteries. Because of the risk of overestimation, occlusions and high grade stenoses should be verified with selective injections or iodinated CM before PTA or operations.