Thursday, January 31, 2008 - 9:08 AM
13856

Incidence, Complication, And Treatment of Non-Ionic Contrast Dye Extravasation during Computed Tomography (CT) scan

Dennis Schimpf, MD

Hypothesis: Extravasation of non-ionic contrast dye during CT scan has a low incidence, low complication rate, and is not associated with the need for surgical intervention, unlike previously used ioninc contrast dye. Methods: Institutional review board (IRB) approval was obtained via an expedited request form. After which, a retrospective review of the Medical University of South Carolina Hospital data base was performed from January 10, 2003 through October 28, 2006. Those incidences specifically involving non-ionic contrast extravasation during CT scan were analyzed. Results: A review of our data base revealed that a total of 623 incidences of intravenous infiltration or extravasation were reported from January 10, 2003 through October 28, 2006. Of which, 118 cases were related to non-ionic intravenous CT contrast. During this time period 40,012 CT scans with intravenous contrast delivered via an automated injector were performed at our instituition, for a CT scan related dye extravasation rate of .003% (118/40,012). The department of radiology protocol, required that all patients experiencing contrast dye extravasation be evaluated by the hand surgery service. None of the 118 patients whom experienced extravastation of non-ionic contrast required surgical intervention. Close observation, elevation and the intermittent application of warm compresses led to the complete resolution of symptoms in all patients. Conclusions: 1. The incidence of CT scan related non-ionic contrast extravasation is extremely low. 2. The use of non-ionic contrast (Image 1) in combination with the use of automated injectors has dramatically reduced the complication rate of an extravasation event. 3. The need for surgical intervention following non-ionic contrast extravasation during CT scan is exceedingly rare.