二氧化碳造影在移植肾动脉狭窄诊断和球囊扩张术中的应用

目的：评价用二氧化碳（CO2）作为对比剂行移植肾动脉狭窄诊断和成形术的可行性和有效性。资料与方法：对9例怀疑移植肾动脉狭窄者行CO2数字减影血管造影（CO2－DSA），并对狭窄病变在重叠透视定位下行球囊扩张。其中3例在扩张前后同时行非离子型碘对比剂造影。结果：CO2－DSA均清晰显示吻合口后移植肾动脉50％以上的狭窄，均一次性扩张成功。3例中CO2－DSA与碘对比剂造影结果相符。无血清肌酐显著上升和严重并发症。结论：为避免对比剂可能导致的肾毒性，CO2作为对比剂行移植肾动脉狭窄诊断和球囊扩张术后DSA是可行、有效的。

Carbon Dioxide Angiography: Its Application to the Diagnosis and Balloon Angioplasty of Transplanted Renal Arterial Stenosis

Objective To evaluate the feasibility and effectiveness of using carbon dioxide (CO 2) as a contrast for the diagnostic angiography and balloon angioplasty procedure of transplanted renal arterial stenosis.Materials and Methods DSA using CO 2 as the contrast media was performed in 9 patients with suspected transplanted renal arterial stenosis, and then the balloon- dilated procedure for the stenotic arteries was carried out under fluo-fade guidance. Angiography using nonionic iodinated contrast was done in 3 cases both before and after angioplasty procedure.Results In all cases, CO 2-DSA clearly showed the over 50%-degree stenosis of the transplanted renal artery distal to the anastomotic site, and the balloon dilatation was successful by one technical procedure in all patients. CO 2-DSA results were in accord with nonionic iodinated contrast DSA findings in 3 cases. Neither significant increase of serum creatinine level nor serious complications occurred.Conclusion In order to avoid the potential iodinated contrast-induced nephrotoxicity, it is feasible and effective to use CO 2 as an angiographic contrast for the diagnosis and balloon angioplasty of the transplanted renal arterial stenosis.