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

Michael Winkler, Cynthia Talley, Connor Woodward, Alexander Kingsbury, Frank Appiah, Hossam Elbelasi, Kevin Landwher, Xingzhe Li, Dominik Fleischmann

Research output: Contribution to journalArticlepeer-review

11 Scopus citations

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.

Original languageEnglish (US)
Pages (from-to)203-207
Number of pages5
JournalJournal of cardiovascular computed tomography
Volume11
Issue number3
DOIs
StatePublished - May 2017
Externally publishedYes

Keywords

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

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Cardiology and Cardiovascular Medicine

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