The risk of contrast media extravasation during CT scans can be reduced when venous assessments and prevention protocols are implemented in radiology departments. 

A retrospective analysis of more than 73,000 patients who underwent contrast-enhanced CT scans revealed that interventions to prevent such IV leakages produced measurable reductions in incidents.

The practical solutions to reduce the instances of extravasation of contrast media (ECM) were published recently in Academic Radiology. There, researchers shared how to best prevent the complication when administering contrast media intravenously, as well as why it is important for the radiology team to be vigilant in doing so. 

“Subcutaneous extravasation of contrast media is a well-known complication during contrast-enhanced computed tomography scans, occurring even when appropriate intravenous injection techniques are used,” corresponding author Seitaro Oda, MD, with the department of diagnostic radiology at Kumamoto University, and co-authors explained. “The majority of ECMs reportedly involve small volumes of contrast media and resolve without severe adverse effects. However, severe complications, such as tissue necrosis, neurovascular compromise, or compartment syndrome, can potentially occur.” 

At the researchers’ institution, strategic venous assessments before IV contrast administration began in January 2015. The assessments were performed by radiology nurses, who would examine patients’ veins for fragility, swelling, age and the presence or absence of blood regurgitation into the IV access tube. If an issue was encountered, the nurses consulted with radiologists, who then decided how to proceed based on that patient’s situation.