Vasc Spec Int.  2015 Sep;31(3):67-80. 10.5758/vsi.2015.31.3.67.

Carbon Dioxide Angiography: Scientific Principles and Practice

• Cho KJ

• KMID: 2069189
• DOI: http://doi.org/10.5758/vsi.2015.31.3.67

Abstract

Carbon dioxide (CO2) is a colorless, odorless gas which occurs naturally in the atmosphere and human body. With the advent of digital subtraction angiography, the gas has been used as a safe and useful alternative contrast agent in both arteriography and venography. Because of its lack of renal toxicity and allergic potential, CO2 is a preferred contrast agent in patients with renal failure or contrast allergy, and particularly in patients who require large volumes of contrast medium for complex endovascular procedures. Understanding of the unique physical properties of CO2 (high solubility, low viscosity, buoyancy, and compressibility) is essential in obtaining a successful CO2 angiogram and in guiding endovascular intervention. Unlike iodinated contrast material, CO2 displaces the blood and produces a negative contrast for digital subtraction imaging. Indications for use of CO2 as a contrast agent include: aortography and runoff, detection of bleeding, renal transplant arteriography, portal vein visualization with wedged hepatic venous injection, venography, arterial and venous interventions, and endovascular aneurysm repair. CO2 should not be used in the thoracic aorta, the coronary artery, and cerebral circulation. Exploitation of CO2 properties, avoidance of air contamination and facile catheterization technique are important to the safe and effective performance of CO2 angiography and CO2-guided endovascular intervention.

Keyword

Contrast medium; Carbon dioxide; Angiography; Renal failure; Contrast-induced nephropathy

MeSH Terms

Aneurysm
Angiography*
Angiography, Digital Subtraction
Aorta, Thoracic
Aortography
Atmosphere
Carbon Dioxide*
Carbon*
Catheterization
Catheters
Coronary Vessels
Endovascular Procedures
Hemorrhage
Human Body
Humans
Hypersensitivity
Phlebography
Portal Vein
Renal Insufficiency
Solubility
Viscosity
Carbon
Carbon Dioxide