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

Carbon Dioxide As a Standard of Care for Zero Contrast Interventions: When, Why and How?

Author(s): Theodosios Bisdas* and Stylianos Koutsias

Volume 25, Issue 44, 2019

Page: [4662 - 4666] Pages: 5

DOI: 10.2174/1381612825666191129093823

Price: $65

Abstract

Background: Traditional contrast media containing iodine remain the gold standard for vessel visualization during endovascular procedures. On the other hand, their use has several side effects and implications and may cause contrast medium-induced nephropathy. Carbon dioxide (CO2) angiography is an old alternative technique used only for critical patients in order to prevent kidney damages or allergic reactions.

Zero contrast procedure: The availability of automated CO2 injectors has led to an increase in the use of CO2 angiography, providing an option for zero contrast interventions, preserving patient renal function and saving costs for the hospital facility. Taking advantage of the properties of CO2 gas, it is possible to improve the performance of some complex procedures such as atherectomy and the detection of type II endoleaks after EVARs. However, a learning curve is needed to get good imaging, and learn about the qualities and limitations of the technique.

Conclusions: The use of automatic delivery systems for CO2 angiography appears to be a good choice for the use of CO2 as the first imaging option. The standardization of injection protocols and the extensive use of this technique could lead to significant benefits both for the patient's prospects and health facilities.

Keywords: Contrast agents, automated carbon dioxide angiography, zero contrast procedure, contrast induced nephropathy, EVARs, atherectomy.

« Previous Next »
[1]
Subramanian S, Tumlin J, Bapat B, Zyczynski T. Economic burden of contrast-induced nephropathy: implications for prevention strategies. J Med Econ 2007; 10(2): 119-34.
[http://dx.doi.org/10.3111/200710119134] [PMID: 19702434]
[2]
Kidney Disease: Improving global outcomes. KDIGO 2012 Clinical Practice Guideline for the Evaluation and Management of Chronic Kidney Disease. Kidney Int Suppl 2013; 3(1)
[3]
Hoste EAJ, Kellum JA, Selby NM, et al. Global epidemiology and outcomes of acute kidney injury. Nat Rev Nephrol 2018; 14(10): 607-25.
[http://dx.doi.org/10.1038/s41581-018-0052-0] [PMID: 30135570]
[4]
Kristensen SD, Knuuti J, Saraste A, et al. Authors/Task Force Members. 2014 ESC/ESA Guidelines on non-cardiac surgery: cardiovascular assessment and management: The Joint Task Force on non-cardiac surgery: cardiovascular assessment and management of the European Society of Cardiology (ESC) and the European Society of Anaesthesiology (ESA). Eur Heart J 2014; 35(35): 2383-431.
[http://dx.doi.org/10.1093/eurheartj/ehu282] [PMID: 25086026]
[5]
Aumann N, Baumeister SE, Rettig R, et al. Regional variation of chronic kidney disease in Germany: results from two population-based surveys. Kidney Blood Press Res 2015; 40(3): 231-43.
[http://dx.doi.org/10.1159/000368499] [PMID: 25966897]
[6]
Kramer H, Luke A, Bidani A, Cao G, Cooper R, McGee D. Obesity and prevalent and incident CKD: the hypertension detection and follow-up program. Am J Kidney Dis 2005; 46(4): 587-94.
[http://dx.doi.org/10.1053/j.ajkd.2005.06.007] [PMID: 16183412]
[7]
Mahoney EM, Wang K, Keo HH, et al. for REACH investigators. Vascular hospitalization rates and costs in patients with peripheral artery disease in the United States. Circ Cardiovasc Qual Outcomes 2010; 3(6): 642-51.
[http://dx.doi.org/10.1161/CIRCOUTCOMES.109.930735]
[8]
Lüders F, Bunzemeier H, Engelbertz C, et al. CKD and acute and long-term outcome of patients with peripheral artery disease and critical limb ischemia. Clin J Am Soc Nephrol 2016; 11(2): 216-22.
[PMID: 26668023]
[9]
Bisdas T, Borowski M, Torsello G. First-Line Treatments in Patients With Critical Limb Ischemia (CRITISCH) Collaborators. Current practice of first-line treatment strategies in patients with critical limb ischemia. J Vasc Surg 2015; 62(4): 965-73.e3.
[http://dx.doi.org/10.1016/j.jvs.2015.04.441] [PMID: 26187290]
[10]
Bisdas T, Borowski M, Stavroulakis K, Torsello G, CRITISCH Collaborators. Endovascular therapy versus bypass surgery as first-line treatment strategies for critical limb ischemia: results of the interim analysis of the CRITISCH registry. JACC Cardiovasc Interv 2016.
[http://dx.doi.org/10.1016/j.jcin.2016.09.039]
[11]
Morales-Cabeza C, Roa-Medellín D, Torrado I, et al. Immediate reactions to iodinated contrast media. Ann Allergy Asthma Immunol 2017; 119(6): 553-7.
[12]
Patel S, Majmundar SH. Physiology, Carbon Dioxide Retention. In: Treasure Island, FL: StatPearls Publishing 2019.
[13]
Cho KJ. Carbon dioxide angiography: scientific principles and practice. Vasc Spec Int 2015; 31(3): 67-80.
[14]
Caridi J, Cho KJ, Fauria C, Eghbalieh N. Carbon dioxide digital subtraction angiography (CO2 DSA): A comprehensive user guide for all operators. Vascular Disease Management 2014; p. 221.
[15]
Scalise F, Novelli E, Auguadro C, Casali V, Manfredi M, Zannoli R. Automated carbon dioxide digital angiography for lower-limb arterial disease evaluation: safety assessment and comparison with standard iodinated contrast media angiography. J Invasive Cardiol 2015; 27(1): 20-6.
[PMID: 25589696]
[16]
Corazza I, Rossi PL, Feliciani G, Pisani L, Zannoli S, Zannoli R. Mechanical aspects of CO2 angiography. Phys Med 2013; 29(1): 33-8.
[http://dx.doi.org/10.1016/j.ejmp.2011.11.003] [PMID: 22138139]
[17]
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]
[18]
Manzi M, Palena LM. CO2 angiography in diabetic critical limb ischemia patients. Endovascular Today 2017; 16(5): 79-82.
[19]
Castriota F, Nerla R, Micari A, Squeri A, Cremonesi A. Contrast-zero transcatheter aortic valve replacement for patients with severe renal dysfunction: a single-center experience. JACC Cardiovasc Interv 2018; 11(8): 820-2.
[http://dx.doi.org/10.1016/j.jcin.2018.01.280] [PMID: 29673519]
[20]
Zero-contrast directional atherectomy and antirestenotic therapy, Vascupedia GmbH 2019.Available at. https://vascupedia.com/video/vrtd-1-zero-contract-directional-atherectomy-and-antirestenotic-therapy/
[21]
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]
[22]
Mascoli C, Faggioli G, Gallitto E, et al. The assessment of carbon dioxide automated angiography in type II endoleaks detection: comparison with contrast-enhanced ultrasound. Contrast Media Mol Imaging 2018; 2018 7647165
[23]
Dillman JR, Ellis JH, Cohan RH, Strouse PJ, Jan SC. Frequency and Severity of Acute Allergic-Like Reactions to Gadolinium-Containing IV Contrast Media in Children and Adults 2007; 189(6): 1533-8.
[24]
Mehran R, Aymong ED, Nikolsky E, et al. A simple risk score for prediction of contrast-induced nephropathy after percutaneous coronary intervention: development and initial validation. J Am Coll Cardiol 2004; 44(7): 1393-9.
[http://dx.doi.org/10.1016/j.jacc.2004.06.068] [PMID: 15464318]
[25]
de Almeida Mendes C, de Arruda Martins A, Teivelis MP, et al. Carbon dioxide is a cost-effective contrast medium to guide revascularization of TASC A and TASC B femoropopliteal occlusive disease. Ann Vasc Surg 2014; 28(6): 1473-8.
[http://dx.doi.org/10.1016/j.avsg.2014.03.021] [PMID: 24704050]
[26]
Walker CM. Lessons learned: CO2 angiography in the OIS Available at. https://oeisociety.com/wp-content/uploads/2019/04/1545-Lessons-Learned.pdf
[27]
The 2007 Recommendations of the International Commission on Radiological Protection. ICRP Publication 103. Ann ICRP 2007; 37(2-4): 1-332.
[PMID: 18082557]
[28]
Ferrari P, Venturi G, Gualdrini G, Rossi PL, Mariselli M, Zannoli R. Evaluation of the dose to the patient and medical staff in interventional cardiology employing computational models. Radiat Prot Dosimetry 2010; 141(1): 82-5.
[http://dx.doi.org/10.1093/rpd/ncq145] [PMID: 20457663]
[29]
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]
[30]
Alexander JQ. CO2 angiography in lower extremity arterial disease. Endovasc Today 2011; 27-34.
[31]
Zero Contrast EVAR 2019. Available at. https://vascupedia.com/presentation/co2-evar-round-table/
[32]
de Ruiter QM, Gijsberts CM, Hazenberg CE, Moll FL, van Herwaarden JA. Radiation awareness for endovascular abdominal aortic aneurysm repair in the hybrid operating room. An instant patient risk chart for daily practice. J Endovasc Ther 2017; 24(3): 425-34.
[http://dx.doi.org/10.1177/1526602817697188] [PMID: 28393672]

Rights & Permissions Print Cite
Article Metrics
17
© 2024 Bentham Science Publishers | Privacy Policy