[Carbon dioxide as an alternative contrast medium in peripheral angiography]

Area of Science:

• Vascular Imaging
• Interventional Radiology
• Medical Device Technology

Background:

• Iodinated contrast media carry risks, including allergic reactions and nephrotoxicity.
• Alternative contrast agents are needed for patients with contraindications.
• Carbon dioxide (CO2) has been explored as a gaseous contrast agent for angiography.

Purpose of the Study:

• To evaluate the efficacy and safety of CO2 angiography using a closed gas pressure pistol.
• To assess CO2 angiography's utility in various diagnostic and therapeutic vascular procedures.
• To determine image quality and patient tolerance compared to conventional contrast media.

Main Methods:

• A closed gas pressure pistol was utilized for CO2 angiography in 50 patients.
• Procedures included diagnostic pelvis-leg angiographies, therapeutic angiographies, haemodialysis fistula imaging, and renal artery stenosis assessments.
• CO2 dosages ranged from 10 to 100 cm³, with pressures varying from 400 to 2000 mbar.

Main Results:

• CO2 angiography was successfully applied in 50 patients, with 246 renal angiography series performed.
• Minor side effects like transient fullness and nausea occurred in 4 patients.
• Image quality was slightly reduced compared to conventional media due to a higher signal-to-noise ratio.
• Successful visualization of distal aorta, peripheral vessels, upper extremities, and kidney transplants was achieved.

Conclusions:

• Injector-monitored CO2 angiography is a safe and effective supplementary imaging method.
• It is particularly valuable for patients with contraindications to iodinated contrast media.
• The technique enables visualization of complex vascular territories and specific organs like kidney transplants.