Carbon Dioxide Angiography: An Advanced Alternative To Conventional Angiography

Carbon dioxide (CO2) is utilized as an alternate angiographic contrast agent that can be delivered through a hand injection or a pump. However, it is extremely important to understand the unique properties of carbon dioxide, the techniques for its application, the related complications and limitations. A thorough understanding of these aspects is essential for performing the angiography in an effective and safe manner.

Carbon dioxide angiography is primarily of three kinds CO2 renal digital subtraction angiography, CO2 visceral angiography and CO2 angiography of tumors.
Normally, iodinated contrast agents are utilized in medical procedures for diagnosis and treatment of peripheral vascular diseases. Despite the improvement of pre-medication techniques and low-osmolar contrast agents, such agents still produce allergic reactions and contrast-induced nephropathy in certain individuals. To avoid such problems, carbon dioxide angiography is developed in the form of an alternative to the regular iodinated contrast angiography.

The technique is a useful diagnostic procedure, especially for the patients with an improper renal function or who are sensitive to the iodinated contrast material. Moreover, no definite patient preparation is needed for this technique. Additionally, carbon dioxide could be utilized in the form of a contrast agent during outpatient angiography. Presently, carbon dioxide is utilized for producing images of both venous and arterial circulations as well as to assist various endovascular interventions. However, the radiologist must not utilize carbon dioxide in the arteries above diaphragm and within the thoracic aorta. Besides this, heavy sedation must be avoided during the procedure. Hypotension and respiratory depression may be caused by the excessive use of analgesics or sedatives.

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