Carbon dioxide-angiography for patients with peripheral arterial disease at risk of contrast-induced nephropathy

• 作者: Akinsansoye K Dosekun Amol Gupta Vinod Kumar
• 来源期刊: 世界心脏病学杂志:英文版(电子版)
• 学科: 医学
• 关键词: ENDOVASCULAR procedures ANGIOGRAPHY Digital SUBTRACTION Chronic kidney DISEASE PERIPHERAL artery DISEASE Carbon dioxide
• 年，卷（期）: 2020,（2）
• 页码范围: 76-90
• 页数: 15页
• 分类号: R73

摘要

Patients with peripheral arterial disease(PAD)and critical limb ischemia are at risk for limb amputation and require urgent management to restore blood flow.Patients with PAD often have several comorbidities,including chronic kidney disease,diabetes mellitus,and hypertension.Diagnostic and interventional angiography using iodinated contrast agents provides excellent image resolution but can be associated with contrast-induced nephropathy(CIN).The use of carbon dioxide(CO2)as a contrast agent reduces the volume of iodine contrast required for angiography and reduces the incidence of CIN.However,CO2 angiography has been underutilized due to concerns regarding safety and image quality.Modern CO2 delivery systems with advanced digital subtraction angiography techniques and hybrid angiography have improved imaging accuracy and reduced the incidence of CIN.Awareness of the need for optimal imaging conditions,contraindications,and potential complications have improved the safety of CO2 angiography.This review aims to highlight current technological advances in the delivery of CO2 in vascular angiography for patients with PAD and critical limb ischemia,which result in limb preservation while preventing kidney damage.