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Review
. 2017 Sep 26;9(9):715-722.
doi: 10.4330/wjc.v9.i9.715.

Use of carbon dioxide as an intravascular contrast agent: A review of current literature

Fahad Ali  1 , Muhammad Asif Mangi  2 , Hiba Rehman  2 , Edo Kaluski  3
Affiliations
Review

Use of carbon dioxide as an intravascular contrast agent: A review of current literature

Fahad Ali et al. World J Cardiol. .

Abstract

Use of X-ray contrast allows us to differentiate between two or more adjacent structures on radiographic studies. The X-ray contrast agent can be the one with increase X-ray absorption, like iodine and a barium X-ray contrast agent or the one with decrease X-ray absorption like air and carbon dioxide contrast agent. Each contrast agent possesses different risks and benefits in various ways. Carbon dioxide as an intravascular contrast agent can be used as an alternative intravascular contrast agent and has superior results in some cases. In patients with renal dysfunction or iodinated contrast allergy, the use of Iodinated Contrast Agent poses the risk of considerable morbidity. Similarly, use of Gadolinium is discouraged in subject with severe renal dysfunction. Use of carbon dioxide (CO2) as an intravascular contrast, offers an alternative in such patients for certain procedures, as it is not nephrotoxic and it does not incite allergic reactions. It is inexpensive, readily available and due to its unique physical properties, it can be used to image a wide variety of vascular beds and chambers. The aim of this paper is to systemically review the current literature to describe the indications, contraindications, adverse effects, instruments, precautions, latest methodologies and data supporting for the use of CO2 as a contrast agent.

Keywords: Carbon dioxide; Contrast; Gadolinium; Iodinated; Vascular.

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Conflict of interest statement

Conflict-of-interest statement: None of the authors have any conflicts of interest relative to this publication.

Figures

Figure 1
Figure 1
The modified plastic bag system with O-ring.
Figure 2
Figure 2
Potential uses of carbon dioxide angiography. AAA: Abdominal aortic aneurysm.
Figure 3
Figure 3
A carbon dioxide renal arteriogram showing renal artery orifice stenosis with subsequent stent placement and resolution of the stenosis with good flow. The carbon dioxide contrast is injected through the sheath. Adapted with permission from Dr. Kyung Cho.
Figure 4
Figure 4
Carbon dioxide wedged hepatic protogram showing portal vein stenosis (arrow). Adapted with permission from Dr. Kyung Cho.
See this image and copyright information in PMC

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