VASCULAR DISEASE MANAGEMENT
October 2014, Vol. 11, No. 10
Carbon Dioxide Digital Subtraction Angiography (CO2 DSA): A Comprehensive User Guide for All Operators
James G. Caridi, MD, FSIR; Kyung J. Cho, MD; Christina Furia; Navid Eghbalieh, MD
From Tulane University Medical Center, New Orleans, Louisiana.
In 1971 during a routine celiac axis injection, 70 cc of room air was inadvertently injected into a patient instead of iodinated contrast. Fortunately, there were no ill effects and despite the use of cut film at the time, Hawkins visualized the celiac axis and its branches as a negative image. Because of this incident, in combination with his previous knowledge of CO2 in venous imaging, he began to study the intra-arterial use of CO2 in animals. Following the safe, successful use in animals he applied the same principles to humans. Unfortunately, technology lagged behind his genius and the initial imaging was poor. Later, during the 1980s, there was the development of digital subtraction angiography, tilting tables and a safe, reliable delivery system. As technology continued to improve, CO2 evolved into a viable vascular imaging agent. Although used initially for renal failure and iodinated contrast allergy, the many unique properties of CO2 yielded multiple advantages, which are now used in a multitude of scenarios alone or in combination with traditional contrast. It has now been used with great success in both adults and children for over three decades with only limited reportable complications. Its safe use in children has been described and when performed in this age group the same principles as the adult apply. This paper describes the history and technique of CO2 angiography for vascular procedures.
Complete Healing of Spontaneous Coronary Artery Dissection: Serial follow-up using Angiography, Intravascular Ultrasound and Optical Coherence Tomography
Yoshihiro Imai, MD; Takehiro Yamashita, MD
From Cardiovascular Center, Hokkaido Ohno Hospital, Sapporo, Hokkaido, Japan.
Spontaneous coronary artery dissection (SCAD) is a rare cause of acute coronary syndrome (ACS) with the pathophysiology and prognosis remaining poorly understood. We report here a SCAD case, in which serial angiography, intravascular ultrasound (IVUS) and optical coherence tomography (OCT) demonstrated its complete healing.
Renal Artery Interventions: An Interview With Larry J. Diaz, MD
Interview by Jennifer Ford
* Articles are subject to change at the editor’s discretion.