What is the role of carbon dioxide angiography in the workup of renovascular hypertension (RVHT)?

Updated: Dec 01, 2020
  • Author: Rebecca J Schmidt, DO, FACP, FASN; Chief Editor: Vecihi Batuman, MD, FASN  more...
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Answer

Carbon dioxide gas has been used in combination with iodinated based contrast agents for angiography in the treatment of renal artery stenosis and post transplant renal artery stenosis since late 1990s with some success [ref 63-66] This approach allows a reduction in the amount of iodinated contrast needed, hence, decreasing the risk of contrast-induced acute kidney injury. The use of Co2 angiography is not completely risk free, however, and has been linked to mesenteric ischemia, non-fatal myocardial infarction and respiratory failure; its use in procedures above diaphragm is contraindicated [ref 67].  Increased availability of low osmolar agents along with lack of training in the use of this modality has likely led to its infrequent use, though it remains an option for patients at higher risk of contrast-associated acute kidney injury.


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