Patients and methods: This retrospective study included a total of six male patients (mean age 63.5±6.9 years; range, 56 to 72 years) with Rutherford Stage 3-4 who were high-risk for chronic renal failure and underwent percutaneous transluminal angioplasty (PTA) due to iliac or femoropopliteal lesions using CO2-DSA between October 2018 and January 2020. Demographic and clinical characteristics of the patients, ankle-brachial index (ABI) values, and technical success rate were evaluated.

Results: No contrast medium was used in any of the procedure. Technical success rate was 100% and no intraoperative complication was observed. All patients had a non-significant increase in the creatinine levels during follow-up (p=0.076). There was a significant difference between the pre- and postoperative ABI values (p=0.028). All patients were followed in the wards after the procedure and were discharged on postoperative Day 1 with symptomatic recovery.

Conclusion: Our study results show that CO2-DSA can be used as an affordable and effective alternative in the diagnosis and treatment of peripheral arterial disease with contraindications for iodinated contrast material. Keywords : Angiography, carbon dioxide, contrast-induced nephropathy endovascular procedure, peripheral arterial disease