CO(2) angiography.

Iodinated contrast agents are routinely used in procedures to diagnose and treat peripheral vascular disease. Despite the development of low-osmolar contrast agents and premedication techniques, these agents are still associated with contrast-induced nephropathy and allergic reactions in some individuals. To overcome these problems, carbon dioxide angiography has been developed as an alternative to standard iodinated contrast angiography in certain patient populations. The technology of digital subtraction angiography has greatly improved the image quality of CO(2) angiography. Understanding the unique properties of CO(2), the techniques for its use, and its associated limitations and complications will allow interventional cardiologists to expand their treatments of atherosclerotic peripheral vascular disease.