Reducing the incidence of venous air embolism in contrast-enhanced CT angiography using preflushing of the power injector

Jia, Xiuqin; Li, X.; Li, J.; Jin, Craig; Chen, J.; Huang, Xing; Wang, Y.; Guo, J.; Yang, Jing

doi:10.1016/j.crad.2019.12.025

Cited by 4 publications

(8 citation statements)

References 19 publications

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“…Consequently, different results will be obtained if the sample size is enlarged in the future. Different from our method, Jia et al used the method of adding the step of preflushing the power injector [ 6 ], which also was effective in reducing the incidence of VAE. However, the study of Jia et al unraveled that there existed moderate-grade air emboli in the control and preflushing groups, whereas our study exhibited no moderate-grade air emboli in the control and case groups.…”

Section: Discussionmentioning

confidence: 99%

“…Venous air embolism (VAE) is a potentially life-threatening complication of intravenous injection or traumatic vascular injury [ 1 – 3 ], and the embolus that causes VAE is known as a venous air embolus. With the widespread use of computed tomography angiography (CTA) and high-pressure injectors, the occurrence rate of venous air emboli in CTA examination has been reported to be as high as 7-23% [ 3 – 5 ], which may cause the occurrence of VAE [ 6 ]. Various factors (such as the volume of introduced air, the speed and geometry of bubbles, the presence of a right to left shunt, and the baseline cardiac function of patients) affect the clinical consequences of VAE, and venous air emboli may result in circulatory col-laps, endothelial damage, cytokine release, microthrombosis, and even tissue ischemia [ 7 ].…”

Section: Introductionmentioning

confidence: 99%

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Reduction of venous air embolism in coronary computed tomography angiography using a modified method of saline test injection

Huang

Xie

et al. 2023

BMC Med Imaging

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Objectives This paper analyzed the feasibility of reducing venous air emboli introduced during tube connection in computed tomography angiography (CTA) through a modified method of saline test injection. Methods A total of 386 cases of patients undergoing coronary CTA examination were randomly arranged into a control group (199 patients underwent conventional saline injection before the CTA examination) and a case group (187 patients underwent modified saline injection before the CTA examination). The two groups were compared for the location (Fisher’s exact test), number (χ2 test), and diameter (Mann-Whitney rank sum test) of the air emboli along the inflow direction of contrast agent within the scan. Results The occurrence rate was 10.55% in the control group and 3.74% in the case group respectively, with a statistically different significance (P = 0.010). In the case group, there were 7 cases of small-grade venous air emboli. In the control group, there were 15 cases of small-grade venous air emboli and 6 cases of moderate-grade venous air emboli. No cases of large-grade venous air emboli were found in both groups. Conclusions The use of this modified method of saline test injection before CTA examination is able to effectively decrease the occurrence of venous air emboli introduced during tube connection, which has some certain practical significance.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Reduction of venous air embolism in coronary computed tomography angiography using a modified method of saline test injection

Huang

Xie

et al. 2023

BMC Med Imaging

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“…Power injection of IV CM is superior to drip infusions for CECT 14,15 . This technique is commonly used; however, complications, such as extravasation and air embolism occasionally occur in the veins.…”

Section: Justification and Objectivesmentioning

confidence: 99%

“…This technique is commonly used; however, complications, such as extravasation and air embolism occasionally occur in the veins. The air produced by various causes during injection may travel to the lungs through the pulmonary arteries, causing interference with gas exchange, ultimately leading to cardiac arrhythmias, pulmonary hypertension, right ventricular strain, and even cardiac failure 14 . Great vigilance is recommended to prevent air embolism during administration of IV CM 11 .…”

Section: Justification and Objectivesmentioning

confidence: 99%

Iatrogenic venous air embolism using the injector in CT studies

Motta-Ramírez,

Santiago-González

2024

ARM

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Objective: Despite having no clinical implication in cases of small volumes of air within the venous system, the radiologist should be aware that such a phenomenon is common. Raise awareness about the importance of using the injector and injection of the contrast medium (CM) in CT studies. Material and methods: An extensive bibliographic review was carried out in the PubMed database, where recent bibliographic information was inquired using the following keywords: Venous air embolism (VAE), Iatrogenic VAE, CT injector, including original studies, and bibliographic reviews. Results: We describe the technique and different procedures to prevent air bubbles from being injected into the bloodstream after the use of the injector. We show 3 examples of clinical cases in which it is demonstrated VAE. There is an underdiagnosis of such an iatrogenic situation, which implies a total change of attitude. Conclusion: Clinicians should be aware of this risk when ordering imaging with CM and identify clinical findings of VAE which represents a wide range of clinical of manifestations, ranging from an incidental finding in a clinically asymptomatic patient to obstructive shock and circulatory failure. VAE should be suspected whenever patients experience sudden onset respiratory distress following IV CM injection It is necessary to have an established protocol in which the responsible team monitors the CM application technique through the injector, and everything related to it.

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“…Genellikle venöz sistemde küçük az miktardaki hava girişi sıklıkla dağılır ve hava embolisi kendiliğinde çözülebilir. Bu nedenle çoğu zaman hastalar özel bir tedavi gerektirmeksizin sadece gözleme alınır (6).…”

Section: Introductionunclassified

64 Dedektörlü Bilgisayarlı Tomografide Kontrast Madde Enjeksiyonu Sonrası Nonfatal Venöz Hava Embolisi Sıklığı ve Lokalizasyonu

KELEŞ¹

2021

Osmangazi̇ Journal of Medicine

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Tanısal ve girişimsel radyolojik işlemlerde kontrast madde verilmesi sırasında venöz hava embolisi nonfatal bir olay olarak görülmektedir. Bu çalışmada, kontrastlı bilgisayarlı tomografide (BT) nonfatal venöz hava embolisinin sıklığını ve lokalizasyonunun tespit edilmesi amaçlanmıştır. Hastanemiz Radyoloji Ünitesinde 1 Ocak 2019-31 Aralık 2019 tarihleri arasında çekilen 1654 kontrastlı toraks bilgisayarlı tomografi tetkiki intravenöz hava varlığı retrospektif olarak değerlendirildi. Tespit edilen venöz hava embolilerin lokalizasyonu, boyutları, kontrast maddenin hangi taraftan verildiği kaydedildi. Bu çalışmada iatrojenik venöz hava embolisi %3.14 oranında görülmüştür. En sık görüldüğü lokalizasyon ana pulmoner arter olup (%1.81) diğer görüldüğü lokalizasyonlar sıklık sırasına göre sol brakiosefalik ven (%0.66), sol subklavyen ven (%0.36), sağ brakiosefalik ven (%0.30), sağ subklavyen ven (%0.24), sağ ventrikül (%0.18) ve sağ atriumdur (%0.18). Venöz hava embolisinin boyutlarına bakıldığında %2.5 oranında küçük, %0.50 oranında orta ve %0.12 oranında büyük hava embolisi görüldü. Radyologlar BT taramada kontrast madde enjeksiyonu sonrası vasküler hava embolisi olabileceğini bilmeli ve dikkatli olmalıdır.

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Reducing the incidence of venous air embolism in contrast-enhanced CT angiography using preflushing of the power injector

Cited by 4 publications

References 19 publications

Reduction of venous air embolism in coronary computed tomography angiography using a modified method of saline test injection

Reduction of venous air embolism in coronary computed tomography angiography using a modified method of saline test injection

Iatrogenic venous air embolism using the injector in CT studies

64 Dedektörlü Bilgisayarlı Tomografide Kontrast Madde Enjeksiyonu Sonrası Nonfatal Venöz Hava Embolisi Sıklığı ve Lokalizasyonu

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