Role of carbon dioxide angiography in management of below knee arterial lesions

Abdulghaffar, Wael; Elganayni, Fady; Saleh, Hala Aly; Abou-Issa, Ahmed H.; Abouelcibaa, Osman

doi:10.1016/j.ejrnm.2012.09.008

Cited by 2 publications

(3 citation statements)

References 6 publications

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“…Similarly leg elevation of approximately 15 to 20 degrees and selective intra-arterial administration of 200 to 300 μg Nitroglycerine for vasodilation is reported to act as adjuncts to augment image quality. [ 19 ]…”

Section: Discussionmentioning

confidence: 99%

Feasibility and safety of automated CO2 angiography in peripheral arterial interventions

Thomas¹,

Viniol²,

König³

et al. 2021

Medicine

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Carbon dioxide (CO2) gas is an established alternative to iodine contrast during angiography in patients with risk of postcontrast acute kidney injury and in those with history of iodine contrast allergy. Different CO2 delivery systems during angiography are reported in literature, with automated delivery system being the latest. The aim of this study is to evaluate the safety, efficacy, and learning curve of an automated CO2 injection system with controlled pressures in peripheral arterial interventions and also to study the patients’ tolerance to the system. From January 2018 to October 2019 peripheral arterial interventions were performed in 40 patients (median age-78 years, interquartile range: 69–84 years) using an automated CO2 injection system with customized protocols, with conventional iodine contrast agent used only as a bailout option. The pain and tolerance during the CO2 angiography were evaluated with a visual analog scale at the end of each procedure. The amount of CO2, iodine contrast used, and radiation dose area product for the interventions were also systematically recorded for all procedures. These values were statistically compared in 2 groups, viz first 20 patients where a learning curve was expected vs the rest 20 patients. All procedures were successfully completed without complications. All patients tolerated the CO2 angiography with a median total pain score of 3 (interquartile range: 3–4), with no statistical difference between the groups (P = .529). The 2 groups were statistically comparable in terms of comorbidities and the type of procedures performed (P = .807). The amount of iodine contrast agent used (24.60 ± 6.44 ml vs 32.70 ± 8.70 ml, P = .006) and the radiation dose area product associated were significantly lower in the second group (2160.74 ± 1181.52 μGym2 vs 1531.62 ± 536.47 μGym2, P = .043). Automated CO2 angiography is technically feasible and safe for peripheral arterial interventions and is well tolerated by the patients. With the interventionalist becoming familiar with the technique, better diagnostic accuracy could be obtained using lower volumes of conventional iodine contrast agents and reduction of the radiation dose involved.

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Section: Discussionmentioning

confidence: 99%

Feasibility and safety of automated CO2 angiography in peripheral arterial interventions

Thomas¹,

Viniol²,

König³

et al. 2021

Medicine

View full text Add to dashboard Cite

show abstract

“…Selective intra-arterial administration of 200 to 300 mg nitroglycerin for vasodilatation. 19 Experience with these and other adjunct maneuvers for optimizing distal vessel filling and CO 2 imaging and the availability of a dedicated CO 2 imaging system may increase the reliability of CO 2 imaging in the below-knee segments and also provides a reliable roadmap to interventional procedures. 13,18,19 Newly developed computerized CO 2 injectors may also further enhance the visualization of the distal arterial segment, owing to flow parameters optimization.…”

Section: Selected Applications Of Co 2 Angiographymentioning

confidence: 99%

“…19 Experience with these and other adjunct maneuvers for optimizing distal vessel filling and CO 2 imaging and the availability of a dedicated CO 2 imaging system may increase the reliability of CO 2 imaging in the below-knee segments and also provides a reliable roadmap to interventional procedures. 13,18,19 Newly developed computerized CO 2 injectors may also further enhance the visualization of the distal arterial segment, owing to flow parameters optimization. 22,23,31 CO 2 is injected through an automatic presettable constant pressure and volume injector to enable nearly complete filling of the vascular space and minimum gas flow fragmentation, resulting in reliable and consistent imaging.…”

Section: Selected Applications Of Co 2 Angiographymentioning

confidence: 99%