Carbon Dioxide Digital Subtraction Angiography for Renal Artery Stent Placement

• Published in: Journal of vascular and interventional radiology Vol. 10; no. 5; pp. 635 - 640
• Main Authors: Caridi, James G., Stavropoulos, S. William, Hawkins, Irvin F.
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.05.1999
• Subjects: Aged; Angiography, contrast media; Angiography, Digital Subtraction - methods; Carbon Dioxide; Contrast Media; Female; Humans; Hypertension, Renovascular - etiology; Male; Middle Aged; Renal angiography; Renal arteries, stenosis; Renal Artery Obstruction - diagnostic imaging; Renal Artery Obstruction - etiology; Renal Artery Obstruction - therapy; Stents; DSA; Renal angiography; Renal arteries, stenosis; Angiography, contrast media; Carbon dioxide; PTA; Contrast media
• ISSN: 1051-0443; 1535-7732
• DOI: 10.1016/S1051-0443(99)70094-1

To determine the efficacy of renal artery stent placement with use of carbon dioxide as the primary contrast agent. Seventeen hypertensive patients with renal ostial stenosis were evaluated and underwent stent placement with use of CO 2 digital subtraction angiography (DSA). Besides hypertension, 11 patients had decreased renal function, three had iodinated contrast material allergy, one patient had both, and two had neither. Supplemental iodinated contrast material (25 mL or less) was used in five patients. Preprocedure and postprocedure serum creatinine levels were obtained to evaluate the effect of CO 2 on renal function. Arteriography was used to evaluate stent positioning. Twenty-three Palmaz stents were placed in 17 patients. Six placements were bilateral, with a total of nine right and 14 left. No additional stents were required to correct malposition. One patient had a mildly significant, yet transient, rise in the postprocedure creatinine level. This patient received 10 mL of iodinated contrast material in addition to CO 2. There were no allergic reactions. The utilization of CO 2 DSA facilitates the accurate placement of renal artery stents by eliminating the concern for contrast material—associated nephropathy and allergy. These attributes, coupled with the benefit of low viscosity, permit unrestricted imaging, guidance, and precise positioning not afforded by iodinated contrast material.