Squeeze maneuver: an easy way to manage radiological contrast-medium extravasation

Contrast-medium extravasation injuries may be self-limited to catastrophic. Adequate prophylactic measures are enforced when risk factors for extravasation are present, and prompt treatment can avoid serious complications.

To describe the squeeze maneuver, an effective method for the treatment of symptomatic contrast-medium extravasation.

Over a 3-month period, eight patients with >50 ml contrast-medium extravasation resulting in vascular compromise of the fingers were managed with the squeeze maneuver as follows. The intravenous catheter used for contrast-medium injection was removed, and the skin around the insertion site was cleaned with povidone-iodine. An 18-gauge needle was then used to puncture five to eight openings near the catheter insertion site as deeply as possible. We then began squeezing from the periphery of the swelling toward the needle holes. As the contrast medium drained, it was swabbed away with iodine-soaked cotton swabs.

In all eight patients, the maneuver was successful with immediate resolution of the vascular compromise.

The squeeze maneuver provides an easy way to manage radiological contrast-medium extravasation and can be performed immediately in the CT suite.