[Current CO₂ angiography]

Carbon dioxide (CO₂) is a very good and validated alternative to iodine-containing contrast media in diagnostic and interventional angiography. Nevertheless, its routinely use is still limited to specialized centers.

The presentation of the current role and limitations of CO₂ in diagnostic and interventional angiography (venous and arterial).

A comprehensive review of the literature regarding CO₂ angiography (physical features, indications, contraindications, applications) was carried out.

The results show that CO₂ can be used as a reliable alternative for diagnostic angiography and to support interventions in many arterial and venous vascular territories. An exception is the intra-arterial use of CO₂ above the diaphragm due to the risk of severe myocardial and cerebral complications, which represents the most important contraindication. Moreover, due to its very low viscosity, CO₂ is more effective than iodine-containing contrast media in detecting bleeding arising from small vessels.

The CO₂ angiography is a safe and effective technique and can be used as valid alternative. In several clinical cases it even offers some advantages compared to iodine-containing contrast media.