CO2 angiography: Colorless, odorless, but definitely not useless!

Key Points

• Contemporary approaches to minimize the risk of acute kidney injury from radiographic contrast (AKI-RC) rely on preferential use of low- or non-ionic contrast; pre-hydration; and limiting contrast volume.
• This study utilized a meta-analysis of 677 patients to compare the risk of AKI-RC after CO₂ peripheral angiography versus iodinated contrast (4.3% vs. 11.1%, odds ratio [OR] 0.465, P = 0.048). There was no difference in AKI-RC in patients with CKD.
• This study has many limitations. CO₂ angiography is an important technique; proper understanding of its strengths and limitations is essential.

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