title: Safety of limited supplemental iodinated contrast administration in azotemic patients undergoing CO2 angiography.
abstract: OBJECTIVE
  To determine if limited doses of iodinated contrast significantly worsen the underlying renal insufficiency that had warranted the use of CO(2) for diagnostic angiography.
  
  
  METHODS
  The records of 122 consecutive patients who had undergone CO(2) angiography for peripheral vascular disease at our institution over a 5-year period were reviewed. The volume and type of iodinated contrast and the volume of CO(2) administered were recorded. Serum creatinine measurements obtained before angiography and from 2 to 3 days after angiography were recorded.
  
  
  RESULTS
  One hundred patients had pre-angiography and post-angiography creatinine levels available for analysis (51 CO(2) only, 49 CO(2) with iodinated contrast). The average pretreatment creatinine level was 2.8+/-1.5 mg/dL (range 1.8-6.6) for the CO(2) only group and 3.0+/-1.4 mg/dL (range 1.8-8.2) for the CO(2) plus iodinated contrast group (p=0.46). After angiography, the mean change in creatinine was +0.17+/-0.87 mg/dL for the CO(2) only group and +0.03+/-0.98 mg/dL in the CO(2) plus contrast group (p=0.27). Complications included 1 patient with a failing renal transplant who received iodinated contrast and ultimately required return to hemodialysis. A second patient had a transient 1-mg/dL rise of creatinine but did not require dialysis.
  
  
  CONCLUSIONS
  This study supports the relative safety of CO(2) angiography with the limited used of iodinated contrast supplementation for diagnostic studies or interventions in azotemic patients with peripheral vascular disease.
authors.affiliation: Vascular Institute for Health and Disease, Albany Medical Center, Albany, New York 12208, USA. dowlink@mail.amc.edu
authors.forename: Kyran
authors.initials: K
authors.lastname: Dowling
authors.forename: Herman
authors.initials: H
authors.lastname: Kan
authors.forename: Gary
authors.initials: G
authors.lastname: Siskin
authors.forename: Brian
authors.initials: B
authors.lastname: Stainken
authors.forename: Jiyong
authors.initials: J
authors.lastname: Ahn
authors.forename: Allen
authors.initials: A
authors.lastname: Herr
authors.forename: R
authors.initials: R
authors.lastname: Clement Darling
mesh_terms: D000792:Angiography / Q000009:adverse effects*; D002245:Carbon Dioxide; D003287:Contrast Media / Q000008:administration & dosage* / Q000009:adverse effects; D003404:Creatinine / Q000097:blood; D006801:Humans; D007455:Iodine / Q000008:administration & dosage* / Q000009:adverse effects; D016491:Peripheral Vascular Diseases / Q000097:blood / Q000150:complications* / Q000000981:diagnostic imaging*; D012189:Retrospective Studies; D014511:Uremia / Q000097:blood / Q000150:complications*
chemical_list: D003287:Contrast Media; D002245:Carbon Dioxide; D007455:Iodine; D003404:Creatinine