AJDRAJNR - American Journal of Neuroradiology

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INTERVENTIONAL

Carbon Dioxide Column Angioscopy: A New Endovascular Imaging Technique

László Miskolczia, James D. Flahertya, Lee R. Gutermana and L. Nelson Hopkinsa

a From the Department of Neurosurgery (L.M.) and the Toshiba Stroke Research Center, School of Medicine and Biomedical Sciences (J.D.F., L.R.G., L.N.H.), University at Buffalo, State University of New York.

Summary: A new angioscopic technique with a CO2 gas medium for prolonged viewing sessions in the carotid artery is described. A stationary column of CO2 gas, angled 17–30° subhorizontally and buoyed against a balloon catheter, can be safely maintained. During 10–20-min sessions in dogs, endothelia, thrombi, stent filaments, coils, and an intimal flap were visualized. This technique eliminates the need for continuous saline infusion, which has prevented the application of angioscopy in the carotid artery.