Safety and Efficacy of Endovascular Therapy With a Simple Homemade Carbon Dioxide Delivery System in Patients With Ileofemoral Artery Diseases

Background: Carbon dioxide (CO2) has been used as an arterial contrast agent for high-risk patients who were allergic to iodinated contrast material and for those with chronic kidney disease (CKD). The feasibility, safety, imaging quality and therapeutic role of CO2 angiography in the endovascular therapy (EVT) for patients with CKD was evaluated. Methods and Results: EVT was performed in 107 consecutive patients with iliofemoral artery disease (148 limbs; mean age, 73±9 years) who were admitted to our hospital from January 2010 to April 2011. Intravascular ultrasound (IVUS)-guided EVT with CO2 was applied for the treatment of 50 patients (70 limbs) with CKD (group 1). IVUS-guided EVT with iodinated contrast media was applied for the treatment of 57 patients (78 limbs) without CKD (group 2). CO2 was injected by hand using a simple homemade delivery system. The overall technical success was 100% in both groups without any major complication. Preprocedure and postprocedure ankle-brachial indices significantly improved in the both groups (0.93±0.11 vs. 0.59±0.19, P