CARBON-DIOXIDE GAS AS AN ARTERIAL CONTRAST AGENT

Objective To investigate the clinical utility of CO2 gas as an arteria l contrast agent, the experience with CO2 arteriography at the Univers ity of Florida was reviewed. Summary Background Data Preliminary studi es have demonstrated the feasibility of CO2 arteriography and shown th at arterial injection of CO2 gas appears non-toxic (which could limit the risks of contrast induced renal injury and allergic reaction). How ever, numerous technical problems make CO2 arteriography a demanding t echnique and recent studies have suggested that distal lower extremity vessels are difficult to image using CO2 arteriography, especially wh en significant arterial occlusive disease is present. Methods One hund red twenty-eight CO2 arteriograms done in 115 patients were reviewed. CO2 arteriograms were graded as excellent, good, poor, or inadequate b y two blinded observers and results of CO2 studies compared to results of standard contrast studies (done in 98 patients for image compariso n). In addition, a therapeutic plan based on the CO2 arteriograms was compared with the therapy each patient received. Results One hundred-s eventeen (91%) of the CO2 arteriograms were of good or excellent quali ty and agreement between CO2 Studies and standard contrast studies was seen in 93 of 98 cases (95%). Accurate therapeutic plans based on CO2 studies were possible in 92% of cases with inadequate visualization o f infrapopliteal arteries being the major limitation (7 cases). No all ergic reactions occurred and only one patient potentially had contrast -induced nephrotoxicity. Conclusions CO2 arteriography provides accura te, clinically useful arterial imaging with minimal risk. Thus, this n ew technology significantly increases the utility of arteriography in patients with peripheral vascular disease.