Carbon dioxide angiography is an established non-nephrotoxic option for imaging of the infradiaphragmatic arteries and veins. Safe performance of the technique once required a somewhat cumbersome system, however, recent innovations have simplified implementation and expanded the user base for this technique. As such, patient access has also increased. In this issue, Hameed et al. provide initial feasibility data regarding carbon dioxide angiography and renal denervation therapy. This experience may be translated into future renovascular interventions in patients with limited renal reserve.