05/06/2026
📢 A new just landed!
We are proud to share important new clinical evidence from Dr. Emiliano Chisci and colleagues, recently published in the European Journal of Vascular and Endovascular Surgery, highlighting the dosimetric impact and best practices of automated CO₂-guided EVAR procedures.
The multicentre prospective Zero Iodine Contrast EVAR Study demonstrates a key message for the vascular community:
➡️ CO₂-guided EVAR is not inherently associated with higher radiation exposure.
When modern imaging systems, optimized low-dose protocols, and synchronized CO₂ DSA techniques are implemented, radiation doses remain comparable to conventional iodinated contrast EVAR procedures while preserving procedural success and image quality.
Key findings include:
✅ Median DAP: 189 Gy·cm² (within European Diagnostic Reference Levels)
✅ Median Air Kerma: ~626 mGy (well below European reference thresholds)
✅ Up to 56% radiation dose reduction compared with pre-optimization workflows
✅ Significant improvements achieved through advanced imaging systems, dedicated low-dose protocols, and CO₂ synchronization techniques
These results further strengthen the role of automated CO₂ angiography as a nephroprotective and environmentally responsible alternative to iodinated contrast media, helping physicians reduce contrast-related risks without compromising procedural performance.
The evidence is clear: success depends not on the contrast agent itself, but on technology optimization, standardized protocols, and operator expertise.
Congratulations to Dr. Emiliano Chisci, Dr. Stefano Michelagnoli, the Zero Iodine Contrast EVAR Collaborative Study Group, and all participating centers for this important contribution to the advancement of vascular care!
