Sr. Kerns et If. Hawkins, CARBON-DIOXIDE DIGITAL SUBTRACTION ANGIOGRAPHY - EXPANDING APPLICATIONS AND TECHNICAL EVOLUTION, American journal of roentgenology, 164(3), 1995, pp. 735-741
Although several noninvasive techniques now exist far vascular imaging
, including MR imaging, three-dimensional CT, and color-flow and duple
x sonography, the gold standard to which these techniques are compared
remains catheter angiography. Cut-film and digital subtraction angiog
raphy (DSA) using iodinated contrast material are the standard methods
by which vascular imaging is performed. However, despite the developm
ent of low-osmolar contrast agents, premedication regimens, and carefu
l patient selection, adverse reactions to contrast material, including
idiosyncratic reactions and contrast-induced nephropathy, continue to
occur in a small number of patients [1-3]. Carbon dioxide (CO2) was d
eveloped as an alternative to iodinated contrast material to avoid the
se problems [4], Once the behavior of intravascular gas, the methods o
f safe delivery, and the principles of successful imaging are understo
od, the use of CO2 as an intravascular contrast agent during DSA allow
s accurate imaging with little risk. Recent advances in delivery syste
ms, postprocessing capabilities, and its extension to new vascular int
erventional procedures have greatly expanded the usefulness of COP ang
iography in both diagnostic and interventional vascular radiology.