Document Detail

CO2 as a contrast medium in endoluminal treatment of high flow vascular malformations.
MedLine Citation:
PMID:  10566518     Owner:  NLM     Status:  MEDLINE    
PURPOSE: To evaluate the diagnostic usefulness of CO2 as a radiologic contrast medium in pre and post-embolization of hemodynamically active vascular malformations. MATERIAL AND METHODS: Eight pre-and post-embolization angiographies were performed on five patients with hemodynamically active vascular malformations. In all cases sequentially iodinated contrast medium and CO2 were used. Procedures were performed using Philips Integris V equipped with specific software to process images obtained with CO2 as contrast medium and with a purpose-built gas injector pump. The images were assessed by three interventional radiologists who evaluated the findings by consensus. They were asked whether uptake of the malformations were better, worse or the same with iodinated contrast and CO2. The images were judged according to the following characteristics; quality, the filling in of the contrast in afferent artery of the HAVM, caliber and number of vessels and existence of pathologic communications in HAVM. These characteristics were assessed in all the patients of the study, both before and after embolization. RESULTS: The CO2 angiographic results were compared to those obtained using iodinated contrast material. Iodinated contrast provided superior image quality in all performed studies. The filling of arterial afference of HAVM was well defined with both contrast media. In all performed cases with CO2, the malformations showed more vessels. No inmediate nor subsequent complications developed with CO2 injections, except in one female patient, who presented an intense sensation of cramps in the lower limbs. CONCLUSION: CO2 is a useful diagnostic and assessment tool before and especially during the embolization of hemodynamically active vascular malformations. It improves quantification and uptake of the malformation's vascular architecture, detecting collateral circulation and arteriovenous shunts. It also detects residual post-embolization disease when iodinated contrast agent is unsuccessful.
E Górriz; J M Carreira; R Reyes; L Gallardo; J M Pulido; A Romero; M Maynar
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Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  European journal of radiology     Volume:  31     ISSN:  0720-048X     ISO Abbreviation:  Eur J Radiol     Publication Date:  1999 Sep 
Date Detail:
Created Date:  1999-12-02     Completed Date:  1999-12-02     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  8106411     Medline TA:  Eur J Radiol     Country:  IRELAND    
Other Details:
Languages:  eng     Pagination:  182-7     Citation Subset:  IM    
Vascular and Interventional Radiology Unit, Hospital Universitario Nuestra Señora del Pino, Las Palmas de Gran Canaria University, Spain.
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MeSH Terms
Angiography / methods*
Arteriovenous Malformations / physiopathology,  radiography*,  therapy*
Carbon Dioxide / diagnostic use*
Contrast Media*
Embolization, Therapeutic
Reg. No./Substance:
0/Contrast Media; 124-38-9/Carbon Dioxide

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