Percutaneous coronary and peripheral angioscopy with saline solution and carbon dioxide gas in porcine and canine arteries

Abstract

To obtain a clear view with angioscopy, blood must be displaced. Carbon dioxide (CO 2) gas has proved to be a safe intraarterial contrast agent, and it may have advantages over saline solution as an infusion medium for angioscopy. This study compared the use of CO 2 gas and saline solution in the femoral artery, in the presence and absence of a proximal occlusion, in nine pigs and six dogs. The applicability of CO 2 gas in the coronary arteries was also evaluated. In total 185 angioscopy procedures were evaluated. With proximal occlusion, angioscopy with CO 2 gas was successful in all 28 peripheral procedures, whereas with saline solution only 65% of the procedures resulted in a clear view ( p < 0.005). Without proximal occlusion, angioscopy was successful with CO 2 gas and saline solution in 61% and 3% of procedures, respectively ( p < 0.0001). Cardiovascular parameters and blood gases showed minor changes after administration of CO 2 gas. During coronary angioscopy with CO 2 gas, mechanical heart failure occurred in all instances, which was lethal in 12 animals. None of the animals died as a result of saline angioscopy. In conclusion, CO 2 gas is a safe medium for angioscopy in the peripheral arteries and in general offers a better view than saline solution. In contrast to saline solution, without proximal balloon occlusion CO 2 gas provided a clear view in 61% of the peripheral procedures. In the coronary arteries, however, CO 2 angioscopy was generally fatal in both animal models.