title: Carbondioxide-Aided Angiography Decreases Contrast Volume and Preserves Kidney Function in Peripheral Vascular Interventions.
abstract: Chronic kidney disease is a common comorbidity in patients with peripheral artery disease. We investigated the safety and efficacy of carbon dioxide (CO2) as supplemental contrast agent to decrease contrast volume during fluoroscopy-guided peripheral vascular procedures in routine angiological practice. We analyzed 191 consecutive interventions of the lower extremity in claudicants and critical limb ischemia (CLI) that were performed with iodinated contrast media (ICM) alone (n = 154) or with the aided or exclusive use of CO2 (n = 37). The technical success rate, total irradiation, and intervention time were not significantly different between ICM and CO2 No severe procedure-related complications occurred. The contrast volume was lower in CO2 than in ICM. Although kidney function, creatinine, and estimated glomerular filtration rate was lower in CO2 at baseline, the incidence of contrast-induced nephropathy was lower in CO2 compared to ICM. These data support CO2 as an alternative supplemental contrast agent that can be applied safely and efficiently to lower contrast volume during peripheral vascular interventions preventing kidney dysfunction even in patients with disease of the popliteal artery and below the knee and CLI.
authors.affiliation: Division of Cardiology, Pulmonology and Vascular Medicine, Medical Faculty, University Duesseldorf, Duesseldorf, Germany.
authors.forename: Emilia
authors.initials: E
authors.lastname: Stegemann
authors.affiliation: Division of Cardiology, Pulmonology and Vascular Medicine, Medical Faculty, University Duesseldorf, Duesseldorf, Germany.
authors.forename: Catharina
authors.initials: C
authors.lastname: Tegtmeier
authors.affiliation: Division of Cardiology, Pulmonology and Vascular Medicine, Medical Faculty, University Duesseldorf, Duesseldorf, Germany.
authors.forename: Nana Yaw
authors.initials: NY
authors.lastname: Bimpong-Buta
authors.affiliation: Division of Cardiology, Pulmonology and Vascular Medicine, Medical Faculty, University Duesseldorf, Duesseldorf, Germany.
authors.forename: Roberto
authors.initials: R
authors.lastname: Sansone
authors.affiliation: Division of Cardiology, Pulmonology and Vascular Medicine, Medical Faculty, University Duesseldorf, Duesseldorf, Germany.
authors.forename: Mark
authors.initials: M
authors.lastname: Uhlenbruch
authors.affiliation: Department of Endocrinology and Diabetology, Medical Faculty, Heinrich-Heine University Duesseldorf, Duesseldorf, Germany.
authors.forename: Andreas
authors.initials: A
authors.lastname: Richter
authors.affiliation: Division of Cardiology, Pulmonology and Vascular Medicine, Medical Faculty, University Duesseldorf, Duesseldorf, Germany.
authors.forename: Berthold
authors.initials: B
authors.lastname: Stegemann
authors.affiliation: Department of Endocrinology and Diabetology, Medical Faculty, Heinrich-Heine University Duesseldorf, Duesseldorf, Germany Institute for Clinical Diabetology, German Diabetes Center, Leibniz Institute for Diabetes Research at Heinrich Heine University, Duesseldorf, Germany German Center for Diabetes Research, Partner Duesseldorf, Germany.
authors.forename: Michael
authors.initials: M
authors.lastname: Roden
authors.affiliation: Division of Cardiology, Pulmonology and Vascular Medicine, Medical Faculty, University Duesseldorf, Duesseldorf, Germany.
authors.forename: Ralf
authors.initials: R
authors.lastname: Westenfeld
authors.affiliation: Division of Cardiology, Pulmonology and Vascular Medicine, Medical Faculty, University Duesseldorf, Duesseldorf, Germany.
authors.forename: Malte
authors.initials: M
authors.lastname: Kelm
authors.affiliation: Division of Cardiology, Pulmonology and Vascular Medicine, Medical Faculty, University Duesseldorf, Duesseldorf, Germany christian.heiss@med.uni-duesseldorf.de.
authors.forename: Christian
authors.initials: C
authors.lastname: Heiss
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000792:Angiography / Q000009:adverse effects / Q000379:methods*; D017130:Angioplasty / Q000009:adverse effects / Q000379:methods*; D002245:Carbon Dioxide / Q000008:administration & dosage* / Q000009:adverse effects; D003287:Contrast Media / Q000008:administration & dosage* / Q000009:adverse effects; D016638:Critical Illness; D005260:Female; D006801:Humans; D007383:Intermittent Claudication / Q000000981:diagnostic imaging / Q000628:therapy*; D007511:Ischemia / Q000000981:diagnostic imaging / Q000628:therapy*; D007668:Kidney / Q000187:drug effects* / Q000503:physiopathology; D007674:Kidney Diseases / Q000139:chemically induced / Q000175:diagnosis / Q000503:physiopathology / Q000517:prevention & control*; D035002:Lower Extremity / Q000098:blood supply*; D008297:Male; D008875:Middle Aged; D058729:Peripheral Arterial Disease / Q000000981:diagnostic imaging / Q000628:therapy*; D011237:Predictive Value of Tests; D015641:Radiography, Interventional / Q000009:adverse effects / Q000379:methods*; D012189:Retrospective Studies; D012307:Risk Factors; D016896:Treatment Outcome
chemical_list: D003287:Contrast Media; D002245:Carbon Dioxide
keywords: angioplasty; carbon dioxide; contrast-induced nephropathy; peripheral artery disease