CARBON-DIOXIDE (CO2) DIGITAL SUBTRACTION ANGIOGRAPHY - 26-YEAR EXPERIENCE AT THE UNIVERSITY-OF-FLORIDA

Although the vascular system is presently being imaged by multiple hig h technology modalities, contrast angiography continues to be the gold standard; however, severe complications rarely occur. During the last 25 years (in over 1400 patients), CO2 has proven to be extremely safe (no allergy or renal failure). However, it is imperative to understan d CO2's physical properties and potential dangers. Recently, CO2 is be ing routinely utilized not only because of safety, but for detection o f minute amounts of bleeding, better collateral filling, and for most interventional procedures since unlimited volumes of CO2 can be inject ed between the catheter and guidewire,Presently, safe, reliable and '' user-friendly'' delivery systems are now commercially available. CO2 P SA images are now nearly comparable to iodinated contrast, and improve ment in DSA images are evolving, including ''stacking'' software.