二酸化炭素(CO₂)シャント造影時におけるバブル法による狭窄血管描出能の向上

抄録

A percutaneous transvascular angioplasty (PTA) is performed to relieve failed vascular access for hemodialysis. Angiography using non-ionic iodinated contrast media is the imaging modality of choice for performing PTA. However, the use of iodinated contrast media is contraindicated for patients with a history of iodine allergy. Since 1920, carbon dioxide (CO₂) has been used as a safe contrast medium in various studies. In CO₂ shunt angiography for hemodialysis, visualization of the vascular structures was often suboptimal due to shunt-specific conditions, such as rapid flow and narrow diameter of the vessels. In the present report, we attempted an improvement of the visualization by injection of CO₂ bubbles in view of the properties of CO₂ (floating and low viscosity). The results indicated that the CO₂ bubbles angiography clearly demonstrated the narrow vessels and stenotic portions that were not visualized by conventional CO₂ angiography. In addition, the required volume of CO₂ could be reduced in comparison with previous studies in the literature. Therefore, the method seemed to be effective in reducing exposure and preventing complication by CO₂. Thus, CO₂ bubbles angiography may be useful for shunt angiography and sequential angioplasty when experiencing shunt problems.