chapter  10
10 Pages

CO2 for Traumatic Bleeding

WithKyung J. Cho

When angiography is performed in patients with traumatic bleeding, CO2 is useful in

the diagnosis and treatment of the vascular injuries and associated bleeding. Because of

the low viscosity, small vascular tears and bleeding can be detected with CO2, which

therefore should be used when searching for any vascular abnormality or the site of

bleeding in patients with blunt or penetrating trauma. Thirty to 50 cc of CO2 can be

injected manually through the standard diagnostic catheter without side holes, eliminat-

ing the need for a pigtail catheter for aortography. The same catheter used for the

aortogram may be used for selective and even superselective catheterization. The angio-

graphic appearance of the bleeding and pseudoaneurysms, with CO2 in abdominal

organ injuries is similar to those with iodinated contrast media. Contrast angiography

provides better resolution and should be performed whenever visualization of detailed

vascular anatomy is needed. CO2 is useful as a contrast agent during transcatheter

embolization for the treatment of bleeding, arteriovenous fistula, and pseudoaneurysm.