title: Carbon dioxide contrast medium for endovascular treatment of ilio-femoral occlusive disease.
abstract: OBJECTIVE
  Compare the use of carbon dioxide contrast medium with iodine contrast medium for the endovascular treatment of ilio-femoral occlusive disease in patients without contraindications to iodine.
  
  
  METHODS
  From August 2012 to August 2014, 21 consecutive patients with ilio-femoral occlusive disease who were eligible for endovascular treatment and lacked contraindications to either iodine contrast or carbon dioxide were randomized into the carbon dioxide or iodine groups and subjected to ilio-femoral angioplasty.We analyzed the feasibility of the procedures, the surgical and clinical outcomes, the procedure lengths, the endovascular material costs, the contrast costs and the quality of the angiographic images in each group.
  
  
  RESULTS
  No conversions to open surgery and no contrast media related complications were noted in either group. A post-operative femoral pulse was present in 88.9% of the iodine group and 80% of the carbon dioxide group. No differences in procedure length, endovascular material cost or renal function variation were noted between the groups. Four patients in the carbon dioxide group required iodine supplementation to complete the procedure. Contrast media expenses were reduced in the carbon dioxide group. Regarding angiographic image quality, 82% of the carbon dioxide images were graded as either good or fair by observers.
  
  
  CONCLUSIONS
  The use of carbon dioxide contrast medium is a good option for ilio-femoral angioplasty in patients without contraindications to iodine and is not characterized by differences in endovascular material costs, procedure duration and surgical outcomes. In addition, carbon dioxide has lower contrast expenses compared with iodine.
authors.affiliation: Hospital Israelita Albert Einstein, São Paulo/, SP, Brazil.
authors.forename: Cynthia de Almeida
authors.initials: Cde A
authors.lastname: Mendes
authors.affiliation: Hospital Israelita Albert Einstein, São Paulo/, SP, Brazil.
authors.forename: Alexandre de Arruda
authors.initials: Ade A
authors.lastname: Martins
authors.affiliation: Hospital Israelita Albert Einstein, São Paulo/, SP, Brazil.
authors.forename: Marcelo Passos
authors.initials: MP
authors.lastname: Teivelis
authors.affiliation: Hospital Israelita Albert Einstein, São Paulo/, SP, Brazil.
authors.forename: Sergio
authors.initials: S
authors.lastname: Kuzniec
authors.affiliation: Hospital Israelita Albert Einstein, São Paulo/, SP, Brazil.
authors.forename: Andrea Yasbek Monteiro
authors.initials: AY
authors.lastname: Varella
authors.affiliation: Hospital Israelita Albert Einstein, São Paulo/, SP, Brazil.
authors.forename: Alexandre
authors.initials: A
authors.lastname: Fioranelli
authors.affiliation: Hospital Israelita Albert Einstein, São Paulo/, SP, Brazil.
authors.forename: Nelson
authors.initials: N
authors.lastname: Wolosker
mesh_terms: D000328:Adult; D000368:Aged; D017130:Angioplasty / Q000379:methods*; D001157:Arterial Occlusive Diseases / Q000601:surgery*; D002245:Carbon Dioxide; D003287:Contrast Media; D057510:Endovascular Procedures / Q000379:methods; D005240:Feasibility Studies; D005263:Femoral Artery / Q000601:surgery*; D006801:Humans; D007083:Iliac Artery / Q000601:surgery*; D017613:Iodine Compounds; D008875:Middle Aged; D018709:Statistics, Nonparametric; D016896:Treatment Outcome
chemical_list: D003287:Contrast Media; D017613:Iodine Compounds; D002245:Carbon Dioxide