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J Cardiovasc Comput Tomogr. 2017 May - Jun;11(3):203-207. doi: 10.1016/j.jcct.2017.03.001. Epub 2017 Mar 16.

The use of intraosseous needles for injection of contrast media for computed tomographic angiography of the thoracic aorta.

Author information

1
Department of Radiology, University of Kentucky, Lexington, KY, USA; Division of Cardiovascular Medicine, Department of Internal Medicine, University of Kentucky, Lexington, KY, USA. Electronic address: michael.winkler@uky.edu.
2
Department of Surgery, University of Kentucky, Lexington, KY, USA.
3
Department of Radiology, University of Kentucky, Lexington, KY, USA.
4
Department of Radiology, University of Kentucky, Lexington, KY, USA; Division of Cardiovascular Medicine, Department of Internal Medicine, University of Kentucky, Lexington, KY, USA.
5
Department of Radiology, Stanford University, Stanford, CA, USA.

Abstract

BACKGROUND:

The objective of this study is to evaluate the safety and quality of computed tomographic angiography of the thoracic aorta (CTA-TA) exams performed using intraosseous needle intravenous access (ION-IVA) for contrast media injection (CMI).

METHODS:

All CTA-TA exams at the study institution performed between 1/1/2013 and 8/14/2015 were reviewed retrospectively to identify those exams which had been performed using ION-IVA (ION-exams). ION-exams were then analyzed to determine aortic attenuation and contrast-to-noise ratio (CNR). Linear regression was used to determine how injection rate and other variables affected image quality for ION-exams. Patient electronic medical records were reviewed to identify any adverse events related to CTA-TA or ION-IVA.

RESULTS:

17 (∼0.2%) of 7401 exams were ION-exams. ION-exam CMI rates varied between 2.5 and 4 ml/s. Mean attenuation was 312 HU (SD 88 HU) and mean CNR was 25 (SD 9.9). A strong positive linear association between attenuation and injection rate was found. No immediate or delayed complications related to the ION-exams, or intraosseous needle use in general, occurred.

CONCLUSION:

For CTA-TA, ION-IVA appears to be a safe and effective route for CMI at rates up to 4 ml/s.

KEYWORDS:

Angiography; Computed tomography; Contrast media; Emergency radiology; Injection; Intraosseous needle; Thoracic aorta; Traumatic aortic injury

PMID:
28341196
PMCID:
PMC5784769
DOI:
10.1016/j.jcct.2017.03.001
[Indexed for MEDLINE]
Free PMC Article

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