ABSTRACT
Carbon dioxide (CO2) was in use in the venous system in the 1950s for diagnosing
pericardial effusion. In the 1970s, we pioneered the intraarterial use of CO2. With
the advent of digital subtraction angiography (DSA) in 1980, reliable imaging of
“low-density” contrast material became available. With the addition of high-resolution
DSA, stacking software (adding multiple images), tilting tables, and reliable delivery
systems, CO2 imaging has become nearly comparable to iodinated contrast material.
Presently, CO2 is used not only in patients with contrast material allergies and renal
failure, but also in patients undergoing routine angiographic studies and many interven-
tional procedures.