Login Register Cart 0
Generic placeholder image

Current Pharmaceutical Design

Editor-in-Chief

ISSN (Print): 1381-6128
ISSN (Online): 1873-4286

Back
Journal Home About Journal Editorial Board Journal Insight Current Issue Volumes/Issues
Subscribe
Review Article

Physiology of Intraluminal Administration of Carbon Dioxide as a Contrast Medium

Author(s): Nikolaos Patelis*, Mikes Doulaptsis, Stylianos Kykalos, Eleftherios Spartalis, Anastasios Maskanakis and Sotirios Georgopoulos

Volume 25, Issue 44, 2019

Page: [4656 - 4661] Pages: 6

DOI: 10.2174/1381612825666191209124911

Price: $65

Abstract

Background: Carbon dioxide (CO2) exists in nature around us. In the middle of the 20th century, the intraluminal injection of CO2 demonstrated similar results to those of Digital Subtraction Angiography (DSA) with an iodinated contrast agent (ICA). Since then, the technology behind CO2 DSA has developed significantly.

Objective: The aim of this study is to inform physicians about the unique properties of CO2 and its physiology after intraluminal injection.

Methods: An extensive search for English literature on the properties of CO2 and the physiology of intraluminal administration was conducted using Pubmed.

Results: There is sufficient literature on the properties of CO2 and the physiology of CO2 DSA. A review of this literature explains what happens to the human organism after the injection of CO2.

Conclusion: There is enough evidence that CO2 DSA is both effective, diagnostic and safe, but the properties of CO2 should be taken under consideration as complications occur, although rarely.

Keywords: Carbon dioxide, angiography, medical imaging, venography, digital subtraction angiography, English literature.

« Previous Next »
[1]
Young M, Mohan J. Carbon Dioxide Angiography StatPearls. 2019.Treasure Island (FL): StatPearls Publishing.
[2]
Hawkins IF. Carbon dioxide digital subtraction arteriography. AJR Am J Roentgenol 1982; 139(1): 19-24.
[http://dx.doi.org/10.2214/ajr.139.1.19] [PMID: 6807073]
[3]
Yang X, Manninen H, Soimakallio S. Carbon dioxide in vascular imaging and intervention. Acta Radiol 1995; 36(4): 330-7.
[http://dx.doi.org/10.3109/02841859509173385] [PMID: 7619608]
[4]
Harward TR, Smith S, Hawkins IF, Seeger JM. Follow-up evaluation after renal artery bypass surgery with use of carbon dioxide arteriography and color-flow duplex scanning. J Vasc Surg 1993; 18(1): 23-30.
[http://dx.doi.org/10.1067/mva.1993.41752] [PMID: 8326656]
[5]
Williams M. The merck index: an encyclopedia of chemicals, drugs, and biologicals, 15th Edition Edited by O'Neil M.J., Royal Society of Chemistry, Cambridge, UK ISBN 9781849736701; 2708 pages.. April 2013, $150 with 1-year free access to The Merck Index Online. Drug Dev Res 2013; 74(5): 339.
[6]
Cho DR, Cho KJ, Hawkins IF Jr. Potential air contamination during CO2 angiography using a hand-held syringe: theoretical considerations and gas chromatography. Cardiovasc Intervent Radiol 2006; 29(4): 637-41.
[http://dx.doi.org/10.1007/s00270-005-0019-y] [PMID: 16604407]
[7]
Sharafuddin MJ, Marjan AE. Current status of carbon dioxide angiography. J Vasc Surg 2017; 66(2): 618-37.
[http://dx.doi.org/10.1016/j.jvs.2017.03.446] [PMID: 28735955]
[8]
Cho KJ. Carbon dioxide angiography: scientific principles and practice. Vasc Spec Int 2015; 31(3): 67-80.
[http://dx.doi.org/10.5758/vsi.2015.31.3.67] [PMID: 26509137]
[9]
Cho KJ, Cho DR, Hawkins IF Jr. A simple DSA method to detect air contamination during CO2 venous studies. Cardiovasc Intervent Radiol 2006; 29(4): 642-5.
[http://dx.doi.org/10.1007/s00270-005-0009-0] [PMID: 16604404]
[10]
Safian RD. CO2 angiography: colorless, odorless, but definitely not useless! Catheter Cardiovasc Interv 2017; 90(3): 449-50.
[http://dx.doi.org/10.1002/ccd.27305] [PMID: 28891160]
[11]
Hawkins IF, Cho KJ, Caridi JG. Carbon dioxide in angiography to reduce the risk of contrast-induced nephropathy. Radiol Clin North Am 2009; 47(5): 813-25. [v-vi]
[http://dx.doi.org/10.1016/j.rcl.2009.07.002] [PMID: 19744596]
[12]
Garza L, Fauria C, Caridi JG. Carbon dioxide digital subtraction angiography: everything you need to know and more. J Radiol Nurs 2016; 35(4): 261-74.
[http://dx.doi.org/10.1016/j.jradnu.2016.09.004]
[13]
Ho CF, Chern MS, Wu MH, et al. Carbon dioxide angiography in lower limbs: a prospective comparative study with selective iodinated contrast angiography. Kaohsiung J Med Sci 2003; 19(12): 599-607.
[http://dx.doi.org/10.1016/S1607-551X(09)70513-3] [PMID: 14719557]
[14]
Cronin P, Patel JV, Kessel DO, Robertson I, McPherson SJ. Carbon dioxide angiography: a simple and safe system of delivery. Clin Radiol 2005; 60(1): 123-5.
[http://dx.doi.org/10.1016/j.crad.2004.05.005] [PMID: 15642303]
[15]
Caridi JG. Vascular imaging with carbon dioxide: confidence in a safe, efficacious, user-friendly system. Semin Intervent Radiol 2015; 32(4): 339-42.
[http://dx.doi.org/10.1055/s-0035-1564813] [PMID: 26622095]
[16]
Snow TM, Rice HA. A simple gas injector for carbon dioxide angiography. Clin Radiol 1999; 54(12): 842-4.
[http://dx.doi.org/10.1016/S0009-9260(99)90690-6] [PMID: 10619303]
[17]
Hawkins IF Jr, Caridi JG, Klioze SD, Mladinich CR. Modified plastic bag system with O-ring fitting connection for carbon dioxide angiography. AJR Am J Roentgenol 2001; 176(1): 229-32.
[http://dx.doi.org/10.2214/ajr.176.1.1760229] [PMID: 11133571]
[18]
Mascoli C, Faggioli G, Gallitto E, et al. Standardization of a carbon dioxide automated system for endovascular aortic aneurysm repair. Ann Vasc Surg 2018; 51: 160-9.
[http://dx.doi.org/10.1016/j.avsg.2018.01.099] [PMID: 29522871]
[19]
Cho KJ. CO2 as a venous contrast agent: safety and tolerance. In: Cho K, Hawkins IF, Eds. Carbon Dioxide Angiography: Principles, Techniques and Practices. 2007; pp. 37-44.
[http://dx.doi.org/10.3109/9781420016260-4]
[20]
Ho JP. Practical Guide to Surgical and Endovascular Hemodialysis Access Management: Case Based Illustration. 2015.
[21]
Caridi JG, Hawkins IF Jr, Klioze SD, Leveen RF. Carbon dioxide digital subtraction angiography: the practical approach. Tech Vasc Interv Radiol 2001; 4(1): 57-65.
[http://dx.doi.org/10.1053/tvir.2001.22006] [PMID: 11981790]
[22]
Barrera F, Durant TM, Lynch PR, Oppenheimer MJ, Stauffer HM, Stewart GH III. In vivo visualization of intracardiac structures with gaseous carbon dioxide; cardiovascular-respiratory effects and associated changes in blood chemistry. Am J Physiol 1956; 186(2): 325-34.
[http://dx.doi.org/10.1152/ajplegacy.1956.186.2.325] [PMID: 13362532]
[23]
Coffey R, Quisling RG, Mickle JP, Hawkins IF Jr, Ballinger WB. The cerebrovascular effects of intraarterial CO2 in quantities required for diagnostic imaging. Radiology 1984; 151(2): 405-10.
[http://dx.doi.org/10.1148/radiology.151.2.6424174] [PMID: 6424174]
[24]
Seeger JM, Self S, Harward TR, Flynn TC, Hawkins IF Jr. Carbon dioxide gas as an arterial contrast agent. Ann Surg 1993; 217(6): 688-97.
[http://dx.doi.org/10.1097/00000658-199306000-00011] [PMID: 8507115]
[25]
Shifrin EG, Plich MB, Verstandig AG, Gomori M. Cerebral angiography with gaseous carbon dioxide CO2. J Cardiovasc Surg (Torino) 1990; 31(5): 603-6.
[PMID: 2121739]
[26]
Dimakakos PB, Stefanopoulos T, Doufas AG, et al. The cerebral effects of carbon dioxide during digital subtraction angiography in the aortic arch and its branches in rabbits. AJNR Am J Neuroradiol 1998; 19(2): 261-6.
[PMID: 9504475]
[27]
Rundback JH, Shah PM, Wong J, Babu SC, Rozenblit G, Poplausky MR. Livedo reticularis, rhabdomyolysis, massive intestinal infarction, and death after carbon dioxide arteriography. J Vasc Surg 1997; 26(2): 337-40.
[http://dx.doi.org/10.1016/S0741-5214(97)70198-8] [PMID: 9279324]
[28]
Mizuno A, Nishi Y, Niwa K. Total bowel ischemia after carbon dioxide angiography in a patient with inferior mesenteric artery occlusion. Cardiovasc Interv Ther 2014; 29(3): 243-6.
[http://dx.doi.org/10.1007/s12928-013-0218-4] [PMID: 24142488]
[29]
Fujihara M, Kawasaki D, Shintani Y, et al. Endovascular therapy by CO2 angiography to prevent contrast-induced nephropathy in patients with chronic kidney disease: a prospective multicenter trial of CO2 angiography registry. Catheter Cardiovasc Interv 2015; 85(5): 870-7.
[http://dx.doi.org/10.1002/ccd.25722] [PMID: 25380326]
[30]
Hawkins IF Jr, Mladinich CR, Storm B, et al. Short-term effects of selective renal arterial carbon dioxide administration on the dog kidney. J Vasc Interv Radiol 1994; 5(1): 149-54.
[http://dx.doi.org/10.1016/S1051-0443(94)71474-3] [PMID: 8136595]
[31]
Palena LM, Diaz-Sandoval LJ, Candeo A, Brigato C, Sultato E, Manzi M. Automated carbon dioxide angiography for the evaluation and endovascular treatment of diabetic patients with critical limb ischemia. J Endovasc Ther 2016; 23(1): 40-8.
[http://dx.doi.org/10.1177/1526602815616924] [PMID: 26567126]
[32]
Kriss VM, Cottrill CM, Gurley JC. Carbon dioxide (CO2) angiography in children. Pediatr Radiol 1997; 27(10): 807-10.
[http://dx.doi.org/10.1007/s002470050239] [PMID: 9323247]
[33]
Chacko S, Joseph G, Thomson V, George P, George O, Danda D. Carbon dioxide angiography-guided renal-related interventions in patients with takayasu arteritis and renal insufficiency. Cardiovasc Intervent Radiol 2018; 41(7): 998-1007.
[http://dx.doi.org/10.1007/s00270-018-1936-x] [PMID: 29549415]
[34]
Cho KJ, Hawkins IF Jr. Discontinuation of the plastic bag delivery system for carbon dioxide angiography will increase radiocontrast nephropathy and life-threatening complications. AJR Am J Roentgenol 2011; 197(5)W940-1
[http://dx.doi.org/10.2214/AJR.11.6639] [PMID: 22021546]
[35]
Miller FJ, Mineau DE, Koehler PR, et al. Clinical intra-arterial digital subtraction imaging. Use of small volumes of iodinated contrast material or carbon dioxide. Radiology 1983; 148(1): 273-8.
[http://dx.doi.org/10.1148/radiology.148.1.6407063] [PMID: 6407063]
[36]
Krasny R, Hollmann JP, Günther RW. [Initial experiences with CO2 as a gaseous contrast medium in digital subtraction angiography]. RoFo Fortschr Geb Rontgenstr Nuklearmed 1987; 146(4): 450-4.
[http://dx.doi.org/10.1055/s-2008-1048519] [PMID: 3033771]
[37]
Takeda T, Ido K, Yuasa Y, et al. Intraarterial digital subtraction angiography with carbon dioxide: superior detectability of arteriovenous shunting. Cardiovasc Intervent Radiol 1988; 11(2): 101-7.
[http://dx.doi.org/10.1007/BF02577069] [PMID: 3134131]
[38]
Weaver FA, Pentecost MJ, Yellin AE, Davis S, Finck E, Teitelbaum G. Clinical applications of carbon dioxide/digital subtraction arteriography. J Vasc Surg 1991; 13(2): 266-72.
[http://dx.doi.org/10.1016/0741-5214(91)90219-K] [PMID: 1899274]
[39]
Rees CR, Niblett RL, Lee SP, Diamond NG, Crippin JS. Use of carbon dioxide as a contrast medium for transjugular intrahepatic portosystemic shunt procedures. J Vasc Interv Radiol 1994; 5(2): 383-6.
[http://dx.doi.org/10.1016/S1051-0443(94)71508-6] [PMID: 8186613]
[40]
Teshima Y, Iwasaki N. Efficacy of CO2-DSA in embolization. Cancer Chemother Pharmacol 1994; 33(Suppl.): S109-10.
[http://dx.doi.org/10.1007/BF00686679] [PMID: 8137467]
[41]
Miyazono N, Inoue H, Kanetsuki I, Nakajo M. Retrograde visualization of the portal venous system using CO2 intraarterial digital subtraction angiography. Abdom Imaging 1994; 19(4): 330-3.
[http://dx.doi.org/10.1007/BF00198190] [PMID: 8075556]
[42]
Bettmann MA, D’Agostino R, Juravsky LI, Jeffery RF, Tottle A, Goudey CP. Carbon dioxide as an angiographic contrast agent. A prospective randomized trial. Invest Radiol 1994; 29(Suppl. 2): S45-6.
[http://dx.doi.org/10.1097/00004424-199406001-00016] [PMID: 7928269]
[43]
Ehrman KO, Taber TE, Gaylord GM, Brown PB, Hage JP. Comparison of diagnostic accuracy with carbon dioxide versus iodinated contrast material in the imaging of hemodialysis access fistulas. J Vasc Interv Radiol 1994; 5(5): 771-5.
[http://dx.doi.org/10.1016/S1051-0443(94)71599-2] [PMID: 8000128]
[44]
Moos JM, Ham SW, Han SM, et al. Safety of carbon dioxide digital subtraction angiography. Arch Surg 2011; 146(12): 1428-32.
[http://dx.doi.org/10.1001/archsurg.2011.195] [PMID: 22288088]
[45]
Moore RM, Braselton CW Jr. Injections of air and of carbon dioxide into a pulmonary vein. Ann Surg 1940; 112(2): 212-8.
[http://dx.doi.org/10.1097/00000658-194008000-00004] [PMID: 17857631]
[46]
Lambert CR, de Marchena EJ, Bikkina M, Arcement BK. Effects of intracoronary carbon dioxide on left ventricular function in swine. Clin Cardiol 1996; 19(6): 461-5.
[http://dx.doi.org/10.1002/clc.4960190604] [PMID: 8790949]

Rights & Permissions Print Cite
Article Metrics
28
1
Wayfinder Image
© 2024 Bentham Science Publishers | Privacy Policy