Carbon Dioxide Angiography for the Detection of Lower Gastrointestinal Arterial Bleeding Initially Occult to Angiography with Iodinated Contrast Media

• Published in: Journal of vascular and interventional radiology Vol. 33; no. 11; pp. 1329 - 1334
• Main Authors: Sawada, Yusuke, Shimohira, Masashi, Nagai, Keiichi, Kawai, Tatsuya, Ohta, Kengo, Nakayama, Keita, Shibamoto, Yuta
• Format: Journal Article
• Language: English
• Published: United States 01.11.2022
• Subjects: Angiography - adverse effects; Angiography - methods; Arteries; Carbon Dioxide - adverse effects; Contrast Media - adverse effects; Gastrointestinal Hemorrhage - chemically induced; Gastrointestinal Hemorrhage - diagnostic imaging; Humans
• ISSN: 1051-0443; 1535-7732
• DOI: 10.1016/j.jvir.2022.06.028

This study evaluated the utility of carbon dioxide (CO ) in angiography for the detection of lower gastrointestinal arterial bleeding initially occult to angiography with iodinated contrast media. Fourteen patients underwent CO -enhanced angiography. In all patients, extravasation was identified by contrast-enhanced computed tomography but not by initial iodinated contrast-enhanced angiography. After iodinated contrast-enhanced angiography, CO -enhanced angiography was performed from the same catheter position. The detection capability for extravasation on CO -enhanced angiography was evaluated. CO -enhanced angiography allowed for the visualization of extravasation and subsequent transcatheter arterial embolization in 11 of 14 (79%) cases, with extravasation seen during either CO -enhanced angiography (n = 8) or subsequent repeat iodinated contrast-enhanced angiography immediately after negative CO -enhanced angiography (n = 3). Conservative treatment was performed in the remaining 3 cases. In conclusion, CO -enhanced angiography appears useful for identifying occult lower gastrointestinal bleeding.