Successful computed tomography angiogram through tibial intraosseous access: a case report

J Emerg Med. 2013 Aug;45(2):182-5. doi: 10.1016/j.jemermed.2012.11.091. Epub 2013 May 29.

Abstract

Background: Intraosseous access has been used increasingly with proven efficacy in emergent situations for adults when intravenous access could not be obtained.

Objective: Our aim was to demonstrate if tibial intraosseous (IO) is an effective route for iodinated contrast administration and pulmonary vasculature visualization.

Case report: We report on an obtunded patient requiring a computed tomography angiogram to help with diagnosis and tibial IO was the only viable access appropriate to withstand the pressure of a computed tomography iodinated contrast load. Tibial IO access was used successfully for administration of iodinated contrast to evaluate for massive pulmonary embolism in an obtunded patient in extremis secondary to cardiovascular instability.

Conclusions: The pulmonary arteries were opacified and demonstrated a high-quality CT angiogram can be done via tibial IO device.

Keywords: CT angiogram; diagnostic imaging; intraosseous access; iodinated contrast; pulmonary vasculature.

Publication types

  • Case Reports

MeSH terms

  • Angiography / methods*
  • Contrast Media / administration & dosage
  • Humans
  • Infusions, Intraosseous / methods*
  • Iodine / administration & dosage
  • Male
  • Middle Aged
  • Pulmonary Embolism / diagnostic imaging*
  • Tibia
  • Tomography, X-Ray Computed / methods*

Substances

  • Contrast Media
  • Iodine