Dr Patel was appointed as Consultant Vascular Radiologist to The Leeds Teaching Hospitals NHS Trust in 1999. In conjunction with other colleagues within the vascular radiology department, Dr Patel supports the provision of a full range of vascular interventional procedures. He has a particular interest in vascular intervention for patients with liver disease and liver transplantation.

Jai V Patel, David O Kessel and Kate Grayson
Department of Radiology St James's University Hospital, The Leeds Teaching Hospitals, Leeds, UK

Address for correspondence:
Dr Jai Patel MBChB, MRCP, FRCR
Department of Radiology, St James's University Hospital
Beckett Street, Leeds LS9 7TF, UK
Tel: +44 (0)113 206 4047 Fax: +44 (0)113 206 4691
E-mail: jai.patel@leedsth.nhs.uk

Abstract
With improvements in digital data acquisition and manipulation equipment, CO₂ has become a cheap, safe and effective alternative contrast agent in patients with contraindications to conventional iodinated contrast media. Carbon dioxide angiography may also demonstrate the site of gastrointestinal bleeding and endoleaks that are occult on conventional angiography. Unfortunately, CO₂ is not a panacea: image quality is not as reliable as with conventional contrast and it is contraindicated in the supra-diaphragmatic vessels. Intra-arterial CO₂ injection can cause intolerable pain in about 5% of patients.

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