Smits P C, Post M J, Velema E, Rienks R, Borst C
Department of Cardiology, University Hospital Utrecht, The Netherlands.
Am Heart J. 1991 Nov;122(5):1315-22. doi: 10.1016/0002-8703(91)90571-x.
To obtain a clear view with angioscopy, blood must be displaced. Carbon dioxide (CO2) gas has proved to be a safe intraarterial contrast agent, and it may have advantages over saline solution as an infusion medium for angioscopy. This study compared the use of CO2 gas and saline solution in the femoral artery, in the presence and absence of a proximal occlusion, in nine pigs and six dogs. The applicability of CO2 gas in the coronary arteries was also evaluated. In total 185 angioscopy procedures were evaluated. With proximal occlusion, angioscopy with CO2 gas was successful in all 28 peripheral procedures, whereas with saline solution only 65% of the procedures resulted in a clear view (p less than 0.005). Without proximal occlusion, angioscopy was successful with CO2 gas and saline solution in 61% and 3% of procedures, respectively (p less than 0.0001). Cardiovascular parameters and blood gases showed minor changes after administration of CO2 gas. During coronary angioscopy with CO2 gas, mechanical heart failure occurred in all instances, which was lethal in 12 animals. None of the animals died as a result of saline angioscopy. In conclusion, CO2 gas is a safe medium for angioscopy in the peripheral arteries and in general offers a better view than saline solution. In contrast to saline solution, without proximal balloon occlusion CO2 gas provided a clear view in 61% of the peripheral procedures. In the coronary arteries, however, CO2 angioscopy was generally fatal in both animal models.
为了通过血管内镜获得清晰视野，必须驱血。二氧化碳（CO₂）气体已被证明是一种安全的动脉内造影剂，作为血管内镜的灌注介质，它可能比生理盐水具有优势。本研究比较了在9头猪和6只狗身上，在有和没有近端闭塞的情况下，二氧化碳气体和生理盐水在股动脉中的应用情况。还评估了二氧化碳气体在冠状动脉中的适用性。总共评估了185例血管内镜检查操作。在近端闭塞的情况下，所有28例外周操作中使用二氧化碳气体进行血管内镜检查均成功，而使用生理盐水时只有65%的操作获得了清晰视野（p<0.005）。在没有近端闭塞的情况下，使用二氧化碳气体和生理盐水进行血管内镜检查的成功率分别为61%和3%（p<0.0001）。给予二氧化碳气体后，心血管参数和血气显示有轻微变化。在使用二氧化碳气体进行冠状动脉血管内镜检查期间，所有病例均发生机械性心力衰竭，其中12只动物死亡。没有动物因生理盐水血管内镜检查而死亡。总之，二氧化碳气体是外周动脉血管内镜检查的一种安全介质，总体上比生理盐水能提供更好的视野。与生理盐水不同，在没有近端球囊闭塞的情况下，二氧化碳气体在61%的外周操作中提供了清晰视野。然而，在两种动物模型中，冠状动脉二氧化碳血管内镜检查通常都是致命的。
