Computed tomography contrast media extravasation: treatment algorithm and immediate treatment by squeezing with...

Area of Science:

• Radiology
• Plastic Surgery
• Emergency Medicine

Background:

• Contrast media extravasation is a potential complication during imaging procedures, particularly with power injector use.
• Prompt recognition and management are crucial to prevent severe tissue damage and patient discomfort.
• An adverse event reporting system can facilitate timely alerts to relevant departments.

Purpose of the Study:

• To evaluate the effectiveness of immediate management for contrast media extravasation injuries.
• To propose guidelines for the initial management of these injuries, focusing on large-volume cases.
• To assess the safety and efficacy of multiple slit incisions and squeezing for treating extravasation.

Main Methods:

• Retrospective chart review of patients experiencing contrast media extravasation between March 2011 and May 2015.
• Identification of cases with large extravasation volumes (>50 ml) or severe limb pressure.
• Analysis of treatment outcomes following multiple slit incisions and squeezing.

Main Results:

• Eighty cases of contrast media extravasation were reported from approximately 218,000 computed tomography scans.
• Twenty-three patients with large-volume extravasation or severe pressure underwent immediate treatment with multiple slit incisions and squeezing.
• Edema resolved within 1-2 hours, and skin incisions healed within a week, indicating rapid recovery.

Conclusions:

• Immediate management with multiple slit incisions and squeezing is a safe and effective strategy for large-volume contrast media extravasation.
• This intervention rapidly reduces swelling, alleviates patient discomfort, and minimizes skin and soft tissue complications.
• Establishing clear guidelines for initial management is essential for timely and effective intervention in contrast media extravasation injuries.