Carbon dioxide in angiography to reduce the risk of contrast-induced nephropathy.

In the 1970s, Hawkins pioneered the intra-arterial use of carbon dioxide gas for high-risk patients who were allergic to iodinated contrast material and for those with renal failure. With the advent of digital subtraction angiography in 1980, reliable imaging of "low-density" CO(2) contrast agent became available. Subsequently, with the addition of high-resolution of digital subtraction angiography, stacking software (adding multiple images), tilting tables and a reliable, user-friendly delivery system, CO(2) imaging has become nearly comparable to and, in some cases, superior to that of iodinated contrast media. It is the only safe contrast agent for patients in renal failure, which is extremely important in view of the increasing incidence of diabetes and complexities of interventional procedures. The low viscosity of CO(2) not only improves the sensitivities of several diagnostic procedures but may afford advantages for several interventional procedures.

[1]  F. Chang,et al.  Incidence and risk factors for acute renal failure in patients with hepatocellular carcinoma undergoing transarterial chemoembolization: a prospective study , 2004, Liver international : official journal of the International Association for the Study of the Liver.

[2]  B. Heniford,et al.  Safety and accuracy of bedside carbon dioxide cavography for insertion of inferior vena cava filters in the intensive care unit. , 2001, Journal of the American College of Surgeons.

[3]  S. Cowper,et al.  Nephrogenic systemic fibrosis: a population study examining the relationship of disease development to gadolinium exposure. , 2007, Clinical journal of the American Society of Nephrology : CJASN.

[4]  P. Liss,et al.  The effects of carbon dioxide versus ioxaglate in the rat kidney. , 2005, Journal of vascular and interventional radiology : JVIR.

[5]  J. Caridi,et al.  Modified plastic bag system with O-ring fitting connection for carbon dioxide angiography. , 2001, AJR. American journal of roentgenology.

[6]  I. Hawkins,et al.  Carbon Dioxide Angiography: Principles, Techniques, and Practices , 2007 .

[7]  I. Hawkins,et al.  Potential Air Contamination During CO2 Angiography Using a Hand-Held Syringe: Theoretical Considerations and Gas Chromatography , 2006, CardioVascular and Interventional Radiology.

[8]  M. Gomori,et al.  Cerebral angiography with gaseous carbon dioxide CO2. , 1990, The Journal of cardiovascular surgery.

[9]  A. Doufas,et al.  The cerebral effects of carbon dioxide during digital subtraction angiography in the aortic arch and its branches in rabbits. , 1998, AJNR. American journal of neuroradiology.

[10]  J. Caridi,et al.  CO2 splenoportography: preliminary results. , 2003, AJR. American journal of roentgenology.

[11]  Jai V. Patel,et al.  Carbon-Dioxide-Guided Vascular Interventions: Technique and Pitfalls , 2002, CardioVascular and Interventional Radiology.

[12]  C. Lambert,et al.  Effects of intracoronary carbon dioxide on left ventricular function in swine , 1996, Clinical cardiology.

[13]  K. Major,et al.  Carbon dioxide digital subtraction angiography-assisted endovascular aortic aneurysm repair in the azotemic patient. , 2007, Journal of vascular surgery.

[14]  B. Croker,et al.  Short-term effects of selective renal arterial carbon dioxide administration on the dog kidney. , 1994, Journal of vascular and interventional radiology : JVIR.

[15]  J. Caridi,et al.  CO2 fine-needle TIPS. , 1997, Journal of vascular and interventional radiology : JVIR.

[16]  L. Kabbani,et al.  Catheter-less angiography for endovascular aortic aneurysm repair: a new application of carbon dioxide as a contrast agent. , 2008, Journal of vascular surgery.

[17]  S. Sawada,et al.  Intraosseous venography with carbon dioxide contrast agent in percutaneous vertebroplasty. , 2005, AJR. American journal of roentgenology.