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

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 in...

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Bibliographic Details
Published in:Journal of cardiovascular computed tomography 2017-05, Vol.11 (3), p.203-207
Main Authors: Winkler, Michael, MD, Talley, Cynthia, MD, Woodward, Connor, Kingsbury, Alexander, Appiah, Frank, Elbelasi, Hossam, MD, Landwher, Kevin, Li, Xingzhe, Fleischmann, Dominik, MD
Format: Article
Language:English
Subjects:
Angiography
Aorta, Thoracic - diagnostic imaging
Aortography - instrumentation
Aortography - methods
Cardiovascular
Computed tomography
Computed Tomography Angiography - instrumentation
Contrast media
Contrast Media - administration & dosage
Emergency radiology
Equipment Design
Humans
Injection
Injections, Intravenous
Intraosseous needle
Needles
Predictive Value of Tests
Reproducibility of Results
Retrospective Studies
Signal-To-Noise Ratio
Thoracic aorta
Traumatic aortic injury
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Summary: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.
ISSN:1934-5925
1876-861X
DOI:10.1016/j.jcct.2017.03.001