In Reply to: Re: Case 0298_02 -- CT arterial portography posted by Andrew Marsala MD on February 22, 1998 at 23:02:15:
To be sure I undertand correctly, I am assuming you performed transhepatic portal catheterization and direct CO2 portography.
Certainly the safe use of CO2 in the portal vein has been described and published for TIPS applications and is now, I would venture to say, used quite widely. The images obtained with direct splenic vein of portal vein Co2 injection and CO2 can be excellent indeed. There are even practitioners who have performed CO2-only-TIPS. This is an an important adjunctive tool for TIPS when treating patient with impaired renal function and ascites. The degree of renal impairment is, of course, far underestimated by the crude measure of serum creatinine. I think percutaneous injection of Co2 into the portal vein, i.e. without a TIPS, falls into the same safe area as CO2 in TIPS.