[Aorto-arteriography of the lower limbs using carbon dioxide]

Carbon dioxide is often used as a contrast medium for angiocardiography and has recently been proposed for peripheral arteriography. We therefore evaluated this method of opacification in comparison with iodine medium.

From December 1992 to February 1993, arteriographies using carbon dioxide contrast medium were performed in 13 patients (age range 57-83) with severe arteriopathies requiring revascularization: 2 aorta plus renal arteries, 2 aorta plus iliac and lower limb arteries, 9 lower limb arteries only. The intraarterial injections of carbon dioxide were delivered rapidly (< 20 sec) at a rate of 30 cm3/s (50 cm3/injection) for the aorta and 10-15 cm3/s (15-60 cm3/injection) for peripheral arteries. In 8 of the patients, control arteriographies were performed with iopamidol.

The injections of carbon dioxide were well tolerated being painless in 12/13 patients. Digital subtraction images were satisfactory in 6, mediocre but conclusive in 5 and poor in 2. Images of distal arteries were the most difficult to interpret and images of the aorta were generally good. The low viscosity of carbon dioxide allowed the use of small 4F catheters.

Carbon dioxide can be routinely used as a contrast medium, notably in diabetic patients, patients with renal impairment and those who are allergic to iodine based compounds.