The Use of Intraosseous Needles for Injection of Contrast Media for Computed Tomographic Angiography of the Thoracic Aorta

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

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.

Publication types

  • Observational Study

MeSH terms

  • Aorta, Thoracic / diagnostic imaging*
  • Aortography / instrumentation*
  • Aortography / methods
  • Computed Tomography Angiography / instrumentation*
  • Contrast Media / administration & dosage*
  • Equipment Design
  • Humans
  • Injections, Intravenous
  • Needles*
  • Predictive Value of Tests
  • Reproducibility of Results
  • Retrospective Studies
  • Signal-To-Noise Ratio

Substances

  • Contrast Media