title: Transient paralysis from carbon dioxide angiography in a patient after four-vessel endovascular thoracoabdominal aortic aneurysm repair.
abstract: Contrast angiography with carbon dioxide (CO2) is frequently used in patients with renal dysfunction or iodinated contrast allergies, as CO2 is nonallergenic, nontoxic, and rapidly absorbed in the blood. However, when delivered intra-arterially, there is a possibility that CO2 may create a vapor lock with resultant transient ischemia. We describe a case of suspected CO2 embolus to the iliolumbar artery after iliac artery stenting resulting in immediate loss of bilateral lower extremity motor and sensory function. After placement of a spinal drain and elevation of mean arterial blood pressure, the patient had complete return of sensation with improvement in motor function.
authors.affiliation: Division of Vascular and Endovascular Surgery, University of Virginia, Charlottesville, VA 22908, USA.
authors.forename: William F
authors.initials: WF
authors.lastname: Johnston
authors.forename: Alvaro J
authors.initials: AJ
authors.lastname: Zamora
authors.forename: Gilbert R
authors.initials: GR
authors.lastname: Upchurch
mesh_terms: D000368:Aged; D015901:Angiography, Digital Subtraction / Q000009:adverse effects*; D017130:Angioplasty; D017545:Aortic Aneurysm, Thoracic / Q000000981:diagnostic imaging / Q000628:therapy*; D002245:Carbon Dioxide / Q000009:adverse effects*; D003287:Contrast Media / Q000009:adverse effects; D004617:Embolism / Q000175:diagnosis / Q000209:etiology / Q000628:therapy; D006083:Graft Occlusion, Vascular / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy; D006801:Humans; D008297:Male; D010264:Paraplegia / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy; D015607:Stents
chemical_list: D003287:Contrast Media; D002245:Carbon Dioxide