Potential Air Contamination During CO2 Angiography Using a Hand-Held Syringe: Theoretical Considerations and Gas Chromatography

Abstract

Air contamination occurs in hand-held syringes filled with CO2 when they are open to the ambient air. The amounts of air contamination over time are similar among syringes placed in the upright, horizontal, and inverted positions.

Mechanical aspects of CO2 angiography

“…How the gas is injected under the different operative conditions is a consequence of previous positive and negative experiences, and a knowledge of the mechanical behaviour of the gas in the vascular cavity is assumed to be not important [19e22]. The problem of injection control has mainly been tackled to control the pressure, and automatic injectors have been proposed [16,17], but manual injection remains the most common technique even in very sophisticated procedures [6,16,23,24].…”

Carbon dioxide‐based portography: An alternative to conventional imaging with the use of iodinated contrast medium

“…As for the CO 2 injection, a 50‐cc syringe was connected to the tank via three‐way stopcock, and 40 cc of CO 2 was prepared in the syringe. Care was taken to close the tip of the syringe with the stopcock after filling of CO 2 to avoid air contamination 16 . Portograms were taken twice, firstly by CO 2 injection manually and rapidly, and secondly by ICM injection (30 mL, 5 mL/s, Omnipaque300, Daiichi‐Sankyo, Tokyo, Japan) by means of a mechanical injection system (Mark V ProVis, MEDRAD, Warrendale, PA, USA).…”

“…Care was taken to close the tip of the syringe with the stopcock after filling of CO2 to avoid air contamination. 16 Portograms were taken twice, firstly by CO2 injection manually and rapidly, and secondly by ICM injection (30 mL, 5 mL/s, Omnipaque300, Daiichi-Sankyo, Tokyo, Japan) by means of a mechanical injection system (Mark V ProVis, MEDRAD, Warrendale, PA, USA). The approximate time of fluoroscopy was 5 s for CO2 based-images and 10 s for ICMbased images from the beginning of the contrast material injection.…”

CO2 Angiography: Application and Caution

“…These include adverse reactions caused by air contamination or injection of gases other than CO 2 , inadvertent administration of excessive amounts of CO 2 , vapor lock and cardiac arrhythmia or neurologic symptoms associated with central CO 2 reflux from brachial artery injection. [18][19][20] Nausea or vomiting associated with CO 2 injection into proximal abdominal aorta is transient and requires no specific treatment. Body position change from side-to-side may help reduce pain.…”