chapter  13
10 Pages

CO2 Renal Percutaneous Transarterial Angioplasty and Stent Placement

WithIrvin F. Hawkins

At the University of Florida, CO2 is our contrast agent of choice for renal angioplasties

and stent placement. Frequently, multiple injections are required to accurately position

the balloon or stent. CO2 is an ideal contrast agent since it is not nephrotoxic, unlimited

volumes can be injected, and it can easily be injected between the guidewire and

the percutaneous transluminal angioplasty (PTA) or stent catheter. Selective injections

of CO2 between the guidewire and the catheter will always reflux into the

aorta, demonstrating the aorta renal junction (Fig. 1). Frequently, multiple projections

may be required to place the renal artery origin in profile, and, after the optimal

obliquity is obtained, many injections may be required to correctly place the stent

(Fig. 2). We have used CO2 over the last 12 years in the majority of renal arterial inter-

ventions in patients with normal renal function and all patients with renal insufficiency.