High-Pitch Carbon Dioxide Contrasted CT Angiography: Pilot Study

Abstract

CO2-CTA with high-pitch CT was feasible in a limited number of patients. Image-quality scores were on average higher for CO2-CTA than for CO2-FLA, while limited imaging quality in the vessels below the knee needs further work on the CT protocol. An added value of cross-sectional imaging was apparent but needs further quantification.

Contrast induced‐acute kidney injury following peripheral angiography with carbon dioxide versus iodinated contrast media: A meta‐analysis and systematic review of current literature

“…The authors also noted that the limitations in the abdominal imaging (aortoiliac and renal beds) were often due to the presence of bowel loops and gas. It has been observed that in many studies, above the knee CO 2 imaging results are superior to infra‐popliteal imaging—with diagnostic accuracy reported as low as 50% in this latter anatomical region . However, Palena et al reported 89.8% accuracy in patients with severe infra‐popliteal arterial disease (vs. 94.4% for supra‐popliteal lesions)—attributing this higher accuracy to the use of an automated CO 2 injection system as opposed to a conventional hand injection system .…”

Complex interventional iliocaval recanalization due to plasmacytoma and cystic echinococcosis

“…Furthermore, it is important to point out that the performers' degree of experience is elementary for a successful recanalization and a long-term patency rate, especially when treating complex cases such as these, requiring stenting of the iliocaval confl uence as in our second case [15,16]. Beside possible re-stenosis and persistence of symptoms, invasive treatment harbours a low risk of major bleeding from 0.3 -1.1 %, vessel perforation, compartment syndrome, pulmonary embolism from 0.2 % -0.9 %, periprocedural mortality from 0.1 % -0.7 %, stent fracture, and stent dislocation as well as early thrombosis from 1.0 % -6.8 % [3,11,14,17,18]. In addition, it is important to note that the radiation exposure increases with the complexity of the intervention, particularly in young patients undergoing interventions of the inferior vena cava plus both iliac veins, radiation exposures needs to be considered.…”

“…Interventional recanalization is currently recommended for patients with CEAP class 4 -6, and should be considered in patients with CEAP class 3 when compression therapy has failed [5,11]. Results after deep venous interventions in patients with severe PTS were promising regarding patency rates.…”

Carbon dioxide CT angiography during endovascular treatment of bilateral common iliac disease with angio‐CT utilisation

“… suggested that In patients with allergic or nephrotoxic reactions to iodinated contrast media, CT arteriography with CO 2 gas may facilitate the detection of liver tumours and their vascular area’ . Finally, Penzkofer et al ., re‐published on the subject, this time in humans confirming the practical application of their suggested protocol previously published …”

“…The use of CT imaging overcomes this by being able to separate out in space, anatomy which can be difficult in conventional angiography. Performing CTA with iodinated contrast media (intra‐venous or intra‐arterial) can contribute to contrast induced nephropathy …”