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3 . 2025

Endovascular aortic aneurysm repair under the guidance of gas angiography

Abstract

Objective. To develop a safe technique of visualizing the abdominal aorta during endovascular aortic aneurysm repair (EVAR) using an alternative contrast agent – medical carbon dioxide (CO2).

Patients and methods. In 2023–2024, a total of nine 58-to-74-year-old male patients underwent EVAR under the guidance of medical carbon dioxide (CO2). Six patients were preoperatively diagnosed as having chronic kidney disease (CKD).

Results. The technical success of EVAR using medical carbon dioxide (CO2) alone was achieved in 7 patients (77.8%). In 2 patients (22.3%), due to insufficient imaging, we were forced to use combined angiography (CO2 + iohexol). The average amount of injected carbon dioxide in the first group per patient was 350±50 cm3, with the average amount of injected iohexol in the second group of patients equaling 20±5 ml. None of the patients in both groups with CKD required hemodialysis or additional hydration therapy. The parameters of renal markers before and after carboxygraphy did not change.

Conclusion. Medical carbon dioxide (CO2) can be safely and effectively used as a contrast agent during EVAR in patients with CKD.

Keywords: carboxyangiography; endovascular aortic aneurysm repair (EVAR); gas angiography; renal failure; contrast-induced nephropathy, medical carbon dioxide

Funding. The study had no financial support.

Conflict of interest. The authors declare no conflict of interest.

Authors’ contribution. Research concept and design – Zatevakhin I.I., Tsitsiashvili M.Sh., Shipovsky V.N.; collection and processing of material – Frantsevich A.M., Ibragimov S.A.; statistical data processing – Frantsevich A.M., Ibragimov S.A.; writing – Frantsevich A.M., Ibragimov S.A.; editing – Frantsevich A.M., Ibragimov S.A.

For citation: Zatevakhin I.I., Tsitsiashvili M.Sh., Shipovsky V.N., Frantsevich A.M., Ibragimov S.A. Endovascular aortic aneurysm repair under the guidance of gas angiography. Angiology and Vascular Surgery. Journal named after Academician A.V. Pokrovsky. 2025; 31 (3): 53–8. DOI: https://doi.org/10.33029/1027-6661-2025-31-3-53-58

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CHIEF EDITOR
CHIEF EDITOR
Yuri V. Belov
Academician of the Russian Academy of Sciences Doctor of Medical Sciences, Professor, President of the Russian Society of Angiologists and Vascular Surgeons

 

In accordance with the decision of the Presidium of the Russian Society of Angiologists and Vascular Surgeons, the journal "Angiology and Vascular Surgery" will be named after Academician A.V. Pokrovsky starting from No. 2/2022.

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