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cylinder with medicinal CO2, a particle filter and a 3-way stopcock and the entire CO2 aspiration procedure is performed inside a bowl of saline solution. After capturing the required volume of CO2, an additional 3–5 ml of saline solution is aspirated into the syringe to provide a water seal when the tip is kept down. This way, a physical barrier is created between the room air and CO2 contents, which is independent of manual compression and safe from air contamination. We believe this technique is a cheap and easily reproducible alternative, particularly useful in patients with renal impairment or iodinated contrast hypersensitivity. We have satisfactorily used this method in more than 30 cases, confirming its validity. We greatly enjoyed reading the article by Kawasaki et al and believe this technique makes an important contribution towards endovascular surgery.

A Simple Homemade Carbon Dioxide Delivery System for Endovascular Procedures in the Iliofemoral Arteries