title: Safety and efficacy of endovascular therapy with a simple homemade carbon dioxide delivery system in patients with ileofemoral artery diseases.
abstract: BACKGROUND
  Carbon dioxide (CO(2)) has been used as an arterial contrast agent for high-risk patients who were allergic to iodinated contrast material and for those with chronic kidney disease (CKD). The feasibility, safety, imaging quality and therapeutic role of CO(2) angiography in the endovascular therapy (EVT) for patients with CKD was evaluated.
  
  
  RESULTS
  EVT was performed in 107 consecutive patients with iliofemoral artery disease (148 limbs; mean age, 73±9 years) who were admitted to our hospital from January 2010 to April 2011. Intravascular ultrasound (IVUS)-guided EVT with CO(2) was applied for the treatment of 50 patients (70 limbs) with CKD (group 1). IVUS-guided EVT with iodinated contrast media was applied for the treatment of 57 patients (78 limbs) without CKD (group 2). CO(2) was injected by hand using a simple homemade delivery system. The overall technical success was 100% in both groups without any major complication. Preprocedure and postprocedure ankle-brachial indices significantly improved in the both groups (0.93±0.11 vs. 0.59±0.19, P<0.01; 0.95±0.13 vs. 0.62±0.22, P<0.01, respectively). All of the CO(2) arteriograms were good or acceptable imaging quality if assessed by 2 independent observers.
  
  
  CONCLUSIONS
  CO(2) arteriograms, using an inexpensive simple homemade delivery system, are feasible and safe in patients with CKD in the evaluation and for EVT of iliofemoral artery disease.
authors.affiliation: Cardiovascular Division, Department of Internal Medicine, Hyogo College of Medicine, Nishinomiya, Japan.
authors.forename: Daizo
authors.initials: D
authors.lastname: Kawasaki
authors.forename: Kenichi
authors.initials: K
authors.lastname: Fujii
authors.forename: Masashi
authors.initials: M
authors.lastname: Fukunaga
authors.forename: Motomaru
authors.initials: M
authors.lastname: Masutani
authors.forename: Aya
authors.initials: A
authors.lastname: Nakata
authors.forename: Tohru
authors.initials: T
authors.lastname: Masuyama
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D055109:Ankle Brachial Index; D002245:Carbon Dioxide / Q000008:administration & dosage* / Q000009:adverse effects; D016009:Chi-Square Distribution; D002908:Chronic Disease; D003287:Contrast Media / Q000008:administration & dosage* / Q000009:adverse effects; D057510:Endovascular Procedures / Q000009:adverse effects / Q000295:instrumentation*; D004867:Equipment Design; D005240:Feasibility Studies; D005260:Female; D005263:Femoral Artery / Q000000981:diagnostic imaging*; D005919:Glomerular Filtration Rate; D006801:Humans; D007083:Iliac Artery / Q000000981:diagnostic imaging*; D007267:Injections; D007564:Japan; D007674:Kidney Diseases / Q000150:complications / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D015588:Observer Variation; D058729:Peripheral Arterial Disease / Q000150:complications / Q000000981:diagnostic imaging / Q000628:therapy*; D011237:Predictive Value of Tests; D015641:Radiography, Interventional / Q000009:adverse effects / Q000295:instrumentation*; D015203:Reproducibility of Results; D012189:Retrospective Studies; D016896:Treatment Outcome; D018084:Ultrasonography, Interventional
chemical_list: D003287:Contrast Media; D002245:Carbon Dioxide