ABSTRACT
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.
