Carbon dioxide angiography

Carbon dioxide angiography (CO2 angiography) is resorted to in cases of renal failure. Iodinated contrast has the risk of contrast induced acute kidney injury, more so in those with pre-existing renal insufficiency. Earlier those with renal issues were considered for magnetic resonance angiography which was also called dyeless angiography as blood vessels can be visualized with the contrast obtained from moving hydrogen nuclei in water, an important constituent of blood. But for better visualization, gadolinium based contrasts are often used in magnetic resonance angiography. Gadolinium based contrasts have been associated with nephrogenic systemic sclerosis in those with renal failure. Hence the role of carbon dioxide angiography in those with renal failure as carbon dioxide is devoid of any such toxicity. As CO2 is highly soluble in blood and rapidly cleared from circulation, it is ideally suited as a negative contrast agent in those with renal failure. Technique of CO2 angiography is a little more cumbersome than contrast angiography. We need a medical grade carbon dioxide cylinder, three way stop cocks, connector tubings, syringes and a reservoir bag for interim storage of carbon dioxide. Initially the reservoir bag is connected to the CO2  cylinder and CO2 drawn into it multiple times to flush out the room air present in it. After that it the bag can be connected to the angiographic manifold attached to the proximal end of the catheter for CO2 injection [Funaki B et a...
Source: Cardiophile MD - Category: Cardiology Authors: Tags: Angiography and Interventions Source Type: blogs