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Angiographic strategies when iodinated contrast medium is undesirable

Department of Radiology, St James's University Hospital, The Leeds Teaching Hospitals, Beckett Street, Leeds LS9 7TF, UK

• Iodinated contrast media may cause deterioration in renal function, particularly if this is already impaired.
  
• The risk of iodinated contrast media may be reduced by adequate hydration and alteration of drug therapy.
  
• Alternative imaging modalities may be used such as MR angiography and duplex ultrasound.
  
• Carbon dioxide (CO₂) may be used for catheter angiograms, both for diagnosis and intervention.
  
• CO₂ must not be administered intra-arterially above the level of the diaphragm.
  
• MR contrast agents may be used intra-arterially, but are limited by volume and cost.
  

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