Abstract
Endovascular aneurysm repair (EVAR) for abdominal aortic aneurysm has been performed more safely, but we must use iodine contrast media. So we hesitate to perform EVAR for renal insufficiency patients. We have tried to use carbon dioxide to decrease the volume of iodine contrast media. We experienced 115 EVAR cases from May 2007 to May 2011. We divided two groups by preoperative eGFR (estimated glomerular filtration rate). 111 patients were into group IC that preoperative eGFR was over 30 ml/min were performed EVAR using only carbon dioxide. 4 patients were group CD that eGFR was blow 30 ml/min were performed EVAR with iodine contrast media and carbon dioxide. Median volume of iodine contrast media was 193 ml in group IC and 48.5 ml in group CD. We had 4 operation related death but no dialysis case were detected in group CD. And no carbon dioxide related complications were detected too. Any patients did not treat dialysis after EVAR in group CD. We think using carbon dioxide in EVAR for renal insufficiency patients are useful for avoid dialysis.
