Carbon dioxide as a contrast agent to guide vascular interventional procedures

Area of Science:

• Vascular Surgery
• Interventional Radiology
• Medical Imaging

Background:

• Contrast agents are crucial for vascular interventional procedures.
• Iodinated contrast agents pose risks for patients with renal insufficiency or allergies.
• Carbon dioxide (CO2) is explored as a safer alternative contrast agent.

Purpose of the Study:

• To evaluate the efficacy and limitations of carbon dioxide (CO2) as a contrast agent for vascular interventions.
• To assess CO2's utility in patients with compromised renal function or contrast allergies.

Main Methods:

• Twenty-six vascular interventional procedures (21 arterial, 5 venous) were performed on 22 adults.
• CO2 was used as the primary contrast agent, especially for patients with renal insufficiency (n=21) or contrast allergy (n=1).
• Procedures included angioplasty/stenting of renal, iliac, and infrainguinal arteries, bypass graft angioplasty, thrombolysis, and venous procedures.

Main Results:

• Twenty-five of 26 procedures were successful.
• Eight procedures required no iodinated contrast, and 11 used ≤20 ml.
• CO2 was inadequate for seven procedures, particularly intra-abdominal ones.

Conclusions:

• Carbon dioxide (CO2) is a viable contrast agent for various vascular interventions, reducing the need for iodinated contrast.
• Procedures in iliac and infrainguinal arteries often require minimal supplemental iodinated contrast.
• CO2's effectiveness was limited in approximately half of the intra-abdominal procedures studied.