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3 . 2025

Use of carboxyangiography in a patient with critical ischemia, diabetic foot syndrome and stage IV chronic kidney disease

Abstract

Background. Critical lower limb ischemia (CLLI) is an unfavorable prognostic factor in patients from the point of view of both limb loss and mortality. Endovascular operations for this pathology have gained wide acceptance. However, these operations are associated with administration of a liquid iodine-containing contrast agent (ICA) for visualization of arteries. Many such patients have accompanying pathology (chronic kidney disease, diabetes mellitus, etc.) and during angiography with a high dose of ICA there is a risk of developing contrast-induced nephropathy. That is why working with patients having many concomitant diseases and a high risk of nephropathy it is important to use “gaseous” contrast media: carbon dioxide can be used as a contrast agent. Medical carbon dioxide does not possesses nephrotoxicity, causes no allergic reactions and is excreted naturally through the alveoli of pulmonary tissues. Using automatic injector Angiodroid for administration of carbon dioxide makes it possible to decrease the degree of patient’s discomfort, because owing to smoothness of injections and pressure control the pain syndrome disappears almost completely.

Objective. To assess efficacy of using CO2-angiography in treatment of a patient with CLLI, diabetic foot syndrome and stage IV chronic kidney disease.

Patients and methods. Presented herein is a clinical case report of successful endovascular treatment of a male patient with CLLI, diabetic foot syndrome and stage IV chronic kidney disease using carboxyangiography.

Results and discussion. CO2-angiography exhibited good quality during endovascular balloon angioplasty in the patient with CLLI, diabetic foot syndrome and stage IV chronic kidney disease.

Keywords: carboxyangiography; critical ischemia; diabetic foot syndrome; chronic kidney disease; balloon angioplasty

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

Authors’ contribution. Study conception and design – Dzhurakulov Sh.R., Tashliev K.V., Severtsev A.N.; data collection and handling – Tashliev K.V., Ibragimov S.A., Fakhriev Zh.A.; manuscript preparation – Tashliev K.V., Ibragimov S.A.; manuscript revision – Dzhurakulov Sh.R., Tashliev K.V., Fakhriev Zh.A.

For citation: Dzhurakulov Sh.R., Tashliev K.V., Severtsev A.N., Ibragimov S.A., Fakhriev Zh.A. Use of carboxyangiography in a patient with critical ischemia, diabetic foot syndrome and stage IV chronic kidney disease. Angiology and Vascular Surgery. Journal named after Academician A.V. Pokrovsky. 2025; 31 (3): 59–64. DOI: https://doi.org/10.33029/1027-6661-2025-31-3-59-64

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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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