THE PROS AND CONS OF CO2 CT ANGIOGRAPHY VERSUS CONVENTIONAL CONTRAST ENHANCED CT ANGIOGRAPHY IN THE TREATMENT OF PERIPHERAL VASCULAR OCCLUSIONS

Over the past two decades, the field of vascular surgery has experienced tremendous advances in technique and technology. After the description of vascular anastomosis by Dr. Alexis Carrel almost one hundred years ago, the subsequent years were slowly crowned by the differentiation of general and vascular surgeons (Friedman 2016). Notably, surgeons were able to distinguish themselves by developing and acquiring techniques that are specific to operations in vascular surgery. This type of surgery involves diseases associated with the vascular system, which specifically includes the arteries, veins, and the lymphatic structure. Thus, vascular surgery provides treatment for diseases associated with the veins and arteries and is used in cases where less invasive methods cannot be incorporated (Reis and Roever 2017). Importantly, vascular diseases arise from damaged vessels or the presence of inflammations or blood clots leading to the occurrence of illnesses like peripheral vascular disease or peripheral arterial disease (PAD) that is occlusive in nature. Notably, vascular occlusion can be defined as the blockage of blood vessels due to the growth of an abnormality or the accumulation of fat or calcium in the inner lining of the venous structure. Occlusion is a common characteristic of PAD where the diameter of the blood vessels narrows considerably (Rotzinger, Lu, Kawkabani, Marques-Vidal, Fetz and Qanadli 2020). Another good example of peripheral vascular occlusion arises from atherosclerosis. This is an occlusive disease where the arteries harden due to fat or calcium, leading to the narrowing of the internal diameter of the vessels (Rotzinger et al. 2020). Over time, this diameter narrows greatly resulting in the formation of clots that restrict the supply of blood to the entire area past the blockage, leading to the development of PVD/PAD.