{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T02:14:22Z","timestamp":1787019262586,"version":"build-2736575974"},"reference-count":41,"publisher":"SAGE Publications","issue":"2","license":[{"start":{"date-parts":[[2025,10,8]],"date-time":"2025-10-08T00:00:00Z","timestamp":1759881600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Vasc Endovascular Surg"],"published-print":{"date-parts":[[2026,2]]},"abstract":"<jats:p>\n                    <jats:bold>Background:<\/jats:bold>\n                    Endovascular Aneurysm Repair (EVAR) is a proven, safe, and effective treatment; however, its application may be limited by the potential adverse effects of iodinated contrast medium (ICM), which can exacerbate renal function and may be contraindicated in patients with renal insufficiency.\n                    <jats:bold>Purpose:<\/jats:bold>\n                    This review aims to provide an overview of \u201czero-iodine contrast EVAR,\u201d which uses CO\n                    <jats:sub>2<\/jats:sub>\n                    exclusively, as a strategy to mitigate the risk of acute kidney injury (AKI) associated with ICM.\n                    <jats:bold>Research design:<\/jats:bold>\n                    A systematic literature review was conducted in PubMed, Embase, and Cochrane databases following PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines to identify EVAR cases performed using carbon dioxide. The Medical Subject Headings (MeSH) terms used were \u201cendovascular repair AND abdominal aortic aneurysm AND contrast medium\u201d and \u201cendovascular repair AND abdominal aortic aneurysm AND carbon dioxide,\u201d with inclusion criteria limited to articles in English published until December 2024.\n                    <jats:bold>Results:<\/jats:bold>\n                    The literature search yielded 1167 papers. After removing duplicates, titles and abstracts were screened, and 68 papers underwent full-text review. A total of 16 studies were included in the analysis, encompassing 1625 patients. Of these, 837 patients underwent EVAR with ICM, and 788 patients underwent EVAR with CO\n                    <jats:sub>2<\/jats:sub>\n                    . Of these, 510 patients were treated with EVAR using CO\n                    <jats:sub>2<\/jats:sub>\n                    exclusively.\n                    <jats:bold>Conclusions:<\/jats:bold>\n                    Although this method still faces inherent limitations due to the physicochemical characteristics of CO\n                    <jats:sub>2<\/jats:sub>\n                    , its use, when combined with additional technical precautions, enables the achievement of zero-contrast results in standard EVAR procedures.\n                  <\/jats:p>","DOI":"10.1177\/15385744251387760","type":"journal-article","created":{"date-parts":[[2025,10,8]],"date-time":"2025-10-08T23:31:52Z","timestamp":1759966312000},"page":"145-153","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":1,"title":["Optimizing Endovascular Aortic Repair With Carbon Dioxide: A Systematic Review Toward Zero Contrast 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