lCLINICAL INVESTIGATION l Safety of Limited Supplemental Iodinated Contrast Administration in Azotemic Patients Undergoing

l l Purpose: To determine if limited doses of iodinated contrast signi®cantly worsen the un-derlying renal insuf®ciency that had warranted the use of CO2 for diagnostic angiography. Methods: The records of 122 consecutive patients who had undergone CO2 angiography for peripheral vascular disease at our institution over a 5-year period were reviewed. The volume and type of iodinated contrast and the volume of CO2 administered were recorded. Serum creatinine measurements obtained before angiography and from 2 to 3 days after angiography were recorded. Results: One hundred patients had pre-angiography and post-angiography creatinine lev-els available for analysis (51 CO2 only, 49 CO2 with iodinated contrast). The average pre-treatment creatinine level was 2.861.5 mg/dL (range 1.8±6.6) for the CO2 only group and 3.061.4 mg/dL (range 1.8±8.2) for the CO2 plus iodinated contrast group (p50.46). After angiography, the mean change in creatinine was 10.1760.87 mg/dL for the CO2 only group and 10.0360.98 mg/dL in the CO2 plus contrast group (p50.27). Complications included 1 patient with a failing renal transplant who received iodinated contrast and ultimately re-quired return to hemodialysis. A second patient had a transient 1-mg/dL rise of creatinine but did not require dialysis. Conclusions: This study supports the relative safety of CO2 angiography with the limited used of iodinated contrast supplementation for diagnostic studies or interventions in azo-temic patients with peripheral vascular disease. J Endovasc Ther 2003;10:312±316 Key words: angiography, azotemia, carbon dioxide, iodinated contrast agents, contras