ABSTRACT
Although CO2 digital subtraction angiography (DSA) complications have been
extremely rare at our institution over the past 26 years, in order to avoid complications,
one must understand the properties of gas (buoyancy, compression, and problems with
delivery). The most potentially dangerous complication is inadvertent injections of
excessive volumes of CO2, which can cause “vapor lock” of the pulmonary artery and
lead to cardiac arrest. Air contamination can also be a severe problem, causing “vapor
lock” of the pulmonary artery, and possibly causing ischemic changes in the visceral
and peripheral circulation. The majority of these complications can be avoided by using
the plastic bag delivery system or the computerized injector, if both are used correctly.
One should also be aware of other rare potential complications.
