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Date Published:
11/07/2022
Online Published:
11/07/2022
Abstract Views: 110
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Views PDF: 193
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Scientific research
How to Cite
Vu, D. L. (2022). Contrast Media Extravasation Injury. Vietnamese Journal of Radiology and Nuclear Medicine, 19, 56-62. https://doi.org/10.55046/vjrnm.19.383.2015
Contrast Media Extravasation Injury
Main Article Content
Abstract
Extravasation of contrast medium during injection, especially when doing contrast-enhanced CT, is now a common problem. The risk factors include patient factors, the class of contrast medium used, and the injection technique. The mechanisms discussed are effects of osmolality, cytotoxicity, volume, and compression. The clinical picture varies from no subjective complaints to pain, ulcers, and compartment syndrome. However, nearly all cases
can be effectively handled by simple conservative treatment with a cold pack and elevation of the arm. The treatment
and follow-up of the patient must be documented.
Article Details
References
1. Pond GD, Dorr RT (1993) Extravasation injury with nonionic contrast material. AJR 160:203–204.
2. Cohan RH, Ellis JH, Garner WL (1996) Extravasation of radiographic contrast material: recognition, prevention, and treatment. Radiology
200:593–604
3. Federle MP, Chang PJ, Confer S, Ozgun B (1998) Frequency and effects of extravasation of ionic and nonionic CT contrast media during rapid bolus injection. Radiology 206:637–640
4. Runge VM, Dickey KM, Williams NM, Peng X (2002) Local tissue toxicity in response to extravascular extravasation of magnetic resonance contrast media. Invest Radiol 37:393–398
5. Wienbeck S, Fishbach R, Kloska SP et al (2010) Prospective study of access site complications of automated contrast injection with peripheral venous access in MDT. AJR 195:825–829
6. Ayre-Smith G (1982) Tissue necrosis following extravasation of contrast media. J Can Assoc Radiol 33:104
7. Pond GD, Dorr RT, McAleese KA (1992) Skin ulceration from extravasation of low-osmolar contrast medium: a complication of automation. AJR 158:915–916
8. Memolo M, Dyer R, Zagoria RJ (1993) Extravasation injury with nonionic contrast material. AJR 160:203
9. Benson LS, Sathy MJ, Port RB (1996) Forearm compartment syndrome due to automated injection of computed tomography contrast material. J Orthop Trauma 10:433–436
10. Sistrom CL, Gay SB, Peffley L (1991) Extravasation of iopamidol and iohexol during contrastenhanced CT: report of 28 cases. Radiology 176:65–67
11. Gault DT (1993) Extravasation injuries. Br J Plast Surg 46:91–96 Gothlin J (1972) The comparative frequency of extravasal injection at phlebography with steel and plastic cannulas. Clin Radiol 23:183–184
12. Miles SG, Rasmussen JF, Litwiller T (1990) Safe use of an intravenous power injector for CT: experience and protocol. Radiology 176:69–70
13. Kaste SC, Young CW (1996) Safe use of power injectors with central and peripheral venous access devices for pediatric CT. Pediatr Radiol 26:499–501
14. Elam EA, Dorr RT, Lagel KE, Pond GD (1991) Cutaneous ulceration due to contrast extravasation: experimental assessment of injury and potential antidotes. Invest Radiol 26:13–16
15. McAlister WH, Palmer K (1971) The histologic effects of four commonly used contrast media for excretory urography and an attempt to modify the responses. Radiology 99:511–516
16. Upton J, Mulliken JB, Murray JE (1979) Major intravenous extravasation injuries. Am J Surg 137:497–506
17. McCullough M, Davies P, Richardson R (1989) A large trial of intravenous Conray 325 and Niopam 300 to assess immediate and delayed reactions. Br J Radiol 62:260–265
18. Panto PN, Davies P (1986) Delayed reactions to urographic contrast media. Br J Radiol 59:41–44
19. Park KS, Kim SH, Park JH et al (1993) Methods for mitigating softtissue injury after subcutaneous injection of water-soluble contrast media. Invest Radiol 28:332–334
20. Chew FS (2010) Extravasation of iodinated contrast medium during CT: self-assessment module. AJR 195:S80–S85
21. Schummer C, Sakr Y, Steenbeck J et al (2010) Risk of Extravasation after Power Injection of Contrast Media via the Proximal Port of Multilumen Central Venous Catheters: Case Report and Review of the Literature. Rofo 182:14–19
22. Earhart A, McMahon P (2011) Vascular access and contrast media. J Infus Nurs 34:97–105
23. Carrier DA, Ford JJ, Hayman LA (1993) MR appearance of extravasated gadolinium contrast medium. AJNR 14:363–364
24. Katayama H, Yamaguchi K, Kozuka T et al (1990) Adverse reactions to ionic and non-ionic contrast media: a report from the Japanese committee on the safety of contrast media. Radiology 175:621–628
25. Yucha CB, Hastings-Tolsma TM, Szeverenyi N (1994) Effect of elevation on intravenous extravasations. J Intraven Nurs 17:231–234
26. Bellin MF, Jakobsen JA, Tomassin I et al (2002) Contrast media safety committee of the European society of urogenital radiology. Contrast medium extravasation injury: guidelines for prevention and management. Eur Radiol 12:2807–2812
27. Hastings-Tolsma TM, Yucha CB et al (1993) Effect of warm and cold applications on the resolution of IV infiltrations. Res Nurs Health 16:171–178
28. Heckler FR (1989) Current thoughts on extravasation injuries. Clin Plast Surg 16:557–563
29. Wang C, Cohan RH, Ellis JH et al (2007) Frequency, management, and outcome of extravasation of nonionic iodinated contrast medium in 69 657 intravenous injections. Radiology 243:80–87.
30. Young RA (1994) Injury due to extravasation of nonionic contrast material (letter). AJR 162:1499
31. Jakobsen Jacobs JE, Birnbaum BA, Langlotz CP (1998) Contrast media reactions and extravasation: relationship to intravenous injection rates. Radiology 209:411–416.
32. Cohan RH, Dunnick NR, Leder RA, Baker ME (1990a) Extravasation of nonionic contrast media: efficacy of conservative treatment. Radiology 174:65–67
33. Cohan RH, Leder RA, Bolick D et al (1990b) Extravascular extravasation of radiographic contrast media: effects of conventional and low-osmolar contrast agents in the rat thigh. Invest Radiol 25:504–510
34. Kim SH, Park JH, Kim YI et al (1990) Experimental tissue damage after subcutaneous injection of watersoluble contrast media. Invest Radiol 25:678–685
35. Shehadi WH (1975) Adverse reactions to intra-vascularly administered contrast media: a comprehensive study based on a prospective survey.
Radiology 124:145–152
36. Birnbaum BA, Nelson RC, Chezmar JL, Glick SN (1999) Extravasation detection accessory: clinical evaluation in 500 patients. Radiology 212:431–438.
37. Hoff L, Brabrand K, Andersen NB, Medhus S (2008) Monitoring Xray contrast agent injections with Doppler ultrasound. In Proceedings IEEE international ultrasonics symposium. doi: 10.1109.
38. Laurie WS, Wilson L, Kernahan A et al (1984) Intravenous extravasation injuries: the effectiveness of hyaluronidase in their treatment. Ann Plast Surg 13:191–194
39. Loth TS, Jones DEC (1988) Extravasations of radiographic contrast material in the upper extremity. J Hand Surg 13:395–398
40. Vandeweyer E, Heymans O, Deraemaecker R (2000) Extra-vasation injuries and emergency suction
as treatment. Plast Reconstr Surg 105:109–110
2. Cohan RH, Ellis JH, Garner WL (1996) Extravasation of radiographic contrast material: recognition, prevention, and treatment. Radiology
200:593–604
3. Federle MP, Chang PJ, Confer S, Ozgun B (1998) Frequency and effects of extravasation of ionic and nonionic CT contrast media during rapid bolus injection. Radiology 206:637–640
4. Runge VM, Dickey KM, Williams NM, Peng X (2002) Local tissue toxicity in response to extravascular extravasation of magnetic resonance contrast media. Invest Radiol 37:393–398
5. Wienbeck S, Fishbach R, Kloska SP et al (2010) Prospective study of access site complications of automated contrast injection with peripheral venous access in MDT. AJR 195:825–829
6. Ayre-Smith G (1982) Tissue necrosis following extravasation of contrast media. J Can Assoc Radiol 33:104
7. Pond GD, Dorr RT, McAleese KA (1992) Skin ulceration from extravasation of low-osmolar contrast medium: a complication of automation. AJR 158:915–916
8. Memolo M, Dyer R, Zagoria RJ (1993) Extravasation injury with nonionic contrast material. AJR 160:203
9. Benson LS, Sathy MJ, Port RB (1996) Forearm compartment syndrome due to automated injection of computed tomography contrast material. J Orthop Trauma 10:433–436
10. Sistrom CL, Gay SB, Peffley L (1991) Extravasation of iopamidol and iohexol during contrastenhanced CT: report of 28 cases. Radiology 176:65–67
11. Gault DT (1993) Extravasation injuries. Br J Plast Surg 46:91–96 Gothlin J (1972) The comparative frequency of extravasal injection at phlebography with steel and plastic cannulas. Clin Radiol 23:183–184
12. Miles SG, Rasmussen JF, Litwiller T (1990) Safe use of an intravenous power injector for CT: experience and protocol. Radiology 176:69–70
13. Kaste SC, Young CW (1996) Safe use of power injectors with central and peripheral venous access devices for pediatric CT. Pediatr Radiol 26:499–501
14. Elam EA, Dorr RT, Lagel KE, Pond GD (1991) Cutaneous ulceration due to contrast extravasation: experimental assessment of injury and potential antidotes. Invest Radiol 26:13–16
15. McAlister WH, Palmer K (1971) The histologic effects of four commonly used contrast media for excretory urography and an attempt to modify the responses. Radiology 99:511–516
16. Upton J, Mulliken JB, Murray JE (1979) Major intravenous extravasation injuries. Am J Surg 137:497–506
17. McCullough M, Davies P, Richardson R (1989) A large trial of intravenous Conray 325 and Niopam 300 to assess immediate and delayed reactions. Br J Radiol 62:260–265
18. Panto PN, Davies P (1986) Delayed reactions to urographic contrast media. Br J Radiol 59:41–44
19. Park KS, Kim SH, Park JH et al (1993) Methods for mitigating softtissue injury after subcutaneous injection of water-soluble contrast media. Invest Radiol 28:332–334
20. Chew FS (2010) Extravasation of iodinated contrast medium during CT: self-assessment module. AJR 195:S80–S85
21. Schummer C, Sakr Y, Steenbeck J et al (2010) Risk of Extravasation after Power Injection of Contrast Media via the Proximal Port of Multilumen Central Venous Catheters: Case Report and Review of the Literature. Rofo 182:14–19
22. Earhart A, McMahon P (2011) Vascular access and contrast media. J Infus Nurs 34:97–105
23. Carrier DA, Ford JJ, Hayman LA (1993) MR appearance of extravasated gadolinium contrast medium. AJNR 14:363–364
24. Katayama H, Yamaguchi K, Kozuka T et al (1990) Adverse reactions to ionic and non-ionic contrast media: a report from the Japanese committee on the safety of contrast media. Radiology 175:621–628
25. Yucha CB, Hastings-Tolsma TM, Szeverenyi N (1994) Effect of elevation on intravenous extravasations. J Intraven Nurs 17:231–234
26. Bellin MF, Jakobsen JA, Tomassin I et al (2002) Contrast media safety committee of the European society of urogenital radiology. Contrast medium extravasation injury: guidelines for prevention and management. Eur Radiol 12:2807–2812
27. Hastings-Tolsma TM, Yucha CB et al (1993) Effect of warm and cold applications on the resolution of IV infiltrations. Res Nurs Health 16:171–178
28. Heckler FR (1989) Current thoughts on extravasation injuries. Clin Plast Surg 16:557–563
29. Wang C, Cohan RH, Ellis JH et al (2007) Frequency, management, and outcome of extravasation of nonionic iodinated contrast medium in 69 657 intravenous injections. Radiology 243:80–87.
30. Young RA (1994) Injury due to extravasation of nonionic contrast material (letter). AJR 162:1499
31. Jakobsen Jacobs JE, Birnbaum BA, Langlotz CP (1998) Contrast media reactions and extravasation: relationship to intravenous injection rates. Radiology 209:411–416.
32. Cohan RH, Dunnick NR, Leder RA, Baker ME (1990a) Extravasation of nonionic contrast media: efficacy of conservative treatment. Radiology 174:65–67
33. Cohan RH, Leder RA, Bolick D et al (1990b) Extravascular extravasation of radiographic contrast media: effects of conventional and low-osmolar contrast agents in the rat thigh. Invest Radiol 25:504–510
34. Kim SH, Park JH, Kim YI et al (1990) Experimental tissue damage after subcutaneous injection of watersoluble contrast media. Invest Radiol 25:678–685
35. Shehadi WH (1975) Adverse reactions to intra-vascularly administered contrast media: a comprehensive study based on a prospective survey.
Radiology 124:145–152
36. Birnbaum BA, Nelson RC, Chezmar JL, Glick SN (1999) Extravasation detection accessory: clinical evaluation in 500 patients. Radiology 212:431–438.
37. Hoff L, Brabrand K, Andersen NB, Medhus S (2008) Monitoring Xray contrast agent injections with Doppler ultrasound. In Proceedings IEEE international ultrasonics symposium. doi: 10.1109.
38. Laurie WS, Wilson L, Kernahan A et al (1984) Intravenous extravasation injuries: the effectiveness of hyaluronidase in their treatment. Ann Plast Surg 13:191–194
39. Loth TS, Jones DEC (1988) Extravasations of radiographic contrast material in the upper extremity. J Hand Surg 13:395–398
40. Vandeweyer E, Heymans O, Deraemaecker R (2000) Extra-vasation injuries and emergency suction
as treatment. Plast Reconstr Surg 105:109–110