Применение карбоксиангиографии у пациента с критической ишемией, синдромом диабетической стопы и хронической болезнью почек IV стадии

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

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. © 2025, Geotar Media Publishing Group. All rights reserved.