[Carbon dioxide angiography. A new injection system]

Area of Science:

• Vascular Imaging
• Interventional Radiology
• Medical Device Technology

Background:

• Digital subtraction angiography (DSA) traditionally uses iodinated contrast media.
• Iodinated contrast media carry risks, including allergic reactions and nephrotoxicity.
• Alternative contrast agents are needed for specific patient populations.

Purpose of the Study:

• To assess the utility of a novel carbon dioxide (CO2) intravascular injection system (CO2-Angioset) for DSA.
• To evaluate the safety and efficacy of CO2 angiography in various vascular beds.
• To determine the suitability of CO2 angiography for patients with contraindications to iodinated contrast agents.

Main Methods:

• Thirty-nine patients underwent DSA using the CO2-Angioset system between March 1998 and May 1999.
• CO2 angiography was performed on renal arteries, portal vein, and limb vasculature.
• Patients included those with contraindications to iodinated contrast media or poor prior angiography results.
• Hemodynamic and oxygen saturation were monitored; subjective sensations were recorded.

Main Results:

• Adequate visualization was achieved in 82% of CO2 angiography procedures.
• Good depiction of renal arteries and peripheral circulation was noted.
• Portal vein visualization was adequate in 12/18 cases, with limitations in some due to venous anatomy.
• A single transient complication (mesenteric ischemia) occurred, resolving spontaneously.

Conclusions:

• The CO2-Angioset system is a simple, safe, and effective tool for CO2 angiography.
• It is particularly beneficial for patients at risk of allergic reactions to iodinated contrast agents or with renal impairment.
• The system facilitates interventional procedures like arteriovenous fistula embolization and transjugular portosystemic shunting.