[Evaluation of carboxy-angiography in the study of arteriopathy of the lower limbs].
OBJECTIVE
We prospectively compared the safety and the usefulness of CO2 with iodinated contrast material in the study of lower limb arteries.


METHODS
The study included 30 patients (20 men, 10 women, mean age 67) suffering from lower limb ischemia: stage II (3), stage III (13), stage IV (9), Leriche syndrome (1), post-operative (4). We systemically performed an aortic injection (L3), via a 4F catheter, of (1) CO2-DSA (5 to 6 injections of 75 ml at a flow rate of 20 ml/s) and (2) DSA with iodine contrast material (100 ml at a flow rate of 8 ml/s). Patients were monitored for pain and vital signs. Four reviewers did a subjective evaluation of the vessel visibility at five levels (pelvis, thigh, knee, calf, ankle).


RESULTS
No side effect was found. Concerning pain, the patients had the same sensation in 53%; pain was more disagreeable with CO2 in 40%, more disagreeable with iodine in 7%. Concerning vessel visualization, there was a good coherence between the readers and we found the same quality in 61%. CO2 was less informative in 35%, and more informative in 4%. Image quality decreased with fragmentation of the gas and remoteness of injection site.


CONCLUSIONS
CO2 angiography, with electronic injection, is a safe alternative to conventional angiography with iodinated contrast material. The disagreeable sensations can be reduced with explanations given before injection and reducing flow rate. Image stacking software could imitate the side effects of fragmentation of the CO2 bubble. This method appears to be a good alternative for patients with severe renal impairment or allergic problems.
Rolland
Y
Y
Département d'Imagerie Médicale, Hôpital Sud, Rennes.
Duvauferrier
R
R
Lucas
A
A
Gourlay
C
C
Rambeau
M
M
Morcet
N
N
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000792:Angiography; D001157:Arterial Occlusive Diseases / Q000000981:diagnostic imaging; D002245:Carbon Dioxide / Q000009:adverse effects; D003287:Contrast Media; D005069:Evaluation Studies as Topic; D005260:Female; D006801:Humans; D007511:Ischemia / Q000000981:diagnostic imaging*; D007866:Leg / Q000098:blood supply* / Q000000981:diagnostic imaging; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies
D003287:Contrast Media; D002245:Carbon Dioxide
Evaluation de la carboxy-angiographie dans l'étude de l'artériopathie des membres inférieurs.