Standardization of a Carbon Dioxide Automated System for Endovascular Aortic Aneurysm Repair

Starting to Remove Radiation and Iodinated Contrast from the Vascular “Equation”

“…In line with the above, Markar et al 4 recently suggested an increased risk of abdominal cancer after EVAR compared with open AAA repair in a cohort of almost 39000 patients, while a novel automated system for carbon dioxide standardized angiography seems to demonstrate promising results in safely reducing contrast use during EVAR. 5 It might be the case that CEUS is a highly sensitive modality both for EVAR 6 and for IMAD follow-up, as shown in the present study. However, it is technically demanding, more time consuming, needs an experienced operator/interpreter and therefore has not gained wide adoption in clinical practice.…”

Use of carbon dioxide for therapeutic decision-making in endoleaks: a case report

“…However, they reported that CO 2 had higher sensitivity for type II endoleaks than iodinated contrast. 11 Even though CO 2 was manually injected in this case report, it was only when the gas was used that it was possible to detect the type I endoleak.…”

“…However, they reported that CO 2 had higher sensitivity for type II endoleaks than iodinated contrast. 11 …”

The benefit of combined carbon dioxide automated angiography and fusion imaging in preserving perioperative renal function in fenestrated endografting

“…We recently reported the standardization of automated CO 2 angiography during EVAR, demonstrating that it can be considered a safe and effective tool, with a lower rate of collateral effects, excellent visualization of the hypogastric arteries, and favorable endoleak detection. 18 Renal artery visualization remains a critical issue, with lack of visualization in 39% of cases. This occurs particularly when the artery has a posterior origin in largevolume aneurysms.…”

“…14,15 In adjunct, the absence of carbon dioxide (CO 2 ) angiography nephrotoxicity can be of further help in preserving renal function. 16,17 Automated CO 2 angiography has been proposed as an alternative to ICM for standard endovascular aneurysm repair (EVAR), 18,19 but its use in FEVAR has not yet been investigated.…”