• Title/Summary/Keyword: extravasation

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Extravasation during Aneurysm Embolization without Neurologic Consequences. Lessons learned from Complications of Pseudoaneurysm Coiling. Report of 2 Cases

  • Hue, Yun-Hee;Yi, Hyeong-Joong;Kim, Young-Joon
    • Journal of Korean Neurosurgical Society
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    • v.44 no.3
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    • pp.178-181
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    • 2008
  • Although endovascular intervention is the first-line treatment of intracranial aneurysm, intraprocedural rupture or extravasation is still an endangering event. We describe two interesting cases of extravasation during embolotherapy for ruptured peripheral cerebral pseudoaneurysms. Two male patients were admitted after development of sudden headache with presentation of intracerebral and subarachnoid hemorrhage, respectively. Initial angiographic assessment failed to uncover any aneurysmal dilatation in both patients. Two weeks afterwards, catheter angiography revealed aneurysms each in the peripheral middle cerebral artery and anterior inferior cerebellar artery. Under a general anesthesia, endovascular embolization was attempted without systemic heparinization. In each case, sudden extravasation was noted around the aneurysm during manual injection of contrast after microcatheter navigation. Immediate computed tomographic scan showed a large amount of contrast collection within the brain, but they tolerated and made an unremarkable recovery thereafter. Intraprocedural extravasation is an endangering event and needs prompt management, however proximal plugging with coil deployment can be sufficient alternative, if one confronts with peripheral pseudoaneurysm. Peculiar angiographic features are deemed attributable to extremely fragile, porous vascular wall of the pseudoaneurysm. Accordingly, it should be noted that extreme caution being needed to handle such a friable vascular lesion.

An Experimental Study for the Prevention of CT Contrast Media Extravasation with Extravasation Detection Accessory System in Femoral Vein of Rabbit (가토 정맥에서 CT 조영제의 혈관외유출 예방을 위한 EDA 시스템의 실험적 연구)

  • Kweon, Dae-Cheol;Jeong, Seok-Hee;Yang, Sung-Hwan;Cho, Mun-Son;Jang, Keun-Jo;Kim, Sun-Geun;Yoo, Beong-Gyu;Lee, Jong-Seok
    • Progress in Medical Physics
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    • v.17 no.4
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    • pp.238-245
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    • 2006
  • To assess the ability of an extravasation defection accessory (EDA) to detect the clinically important extravascular Injection of iodinated contrast material that was delivered with an automated mechanical power injector. The purpose of this study was to assess the ability of this device during clinically important episodes of extravasation. The EDA system was composed of a strain gage, an amplifier and a computer-based system. In the rabbit experimental cases, there were seven true-positive cases (range of the extravasation volumes: $14{\sim}23 ml$). The algorithm results showed seven true-positive cases (range of the extravasation volumes: $7{\sim}16ml$), nineteen true-negative cases, two false-positive cases and no false-negative cases. The EDA system had a sensitivity of 100% and a specificity of 90% for the detection of clinically important extravasation. The EDA system had good sensitivity for the detection of clinically important extravasation and the EDA system has the clinical potential for the early detection of extravasation of the contrast medium that is administered with power injectors.

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Compartment syndrome due to extravasation of peripheral parenteral nutrition: extravasation injury of parenteral nutrition

  • Park, Huee Jin;Kim, Kyung Hoon;Lee, Hyuk Jin;Jeong, Eui Cheol;Kim, Kee Won;Suh, Dong In
    • Clinical and Experimental Pediatrics
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    • v.58 no.11
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    • pp.454-458
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    • 2015
  • Compartment syndrome is a rare but devastating condition that can result in permanent neuromuscular or soft tissue injuries. Extravasation injuries, among the iatrogenic causes of compartment syndrome, occur under a wide variety of circumstances in the inpatient setting. Total parenteral nutrition via a peripheral route is an effective alternative for the management of critically ill children who do not obtain adequate nutrition via the oral route. However, there is an inherent risk of extravasation, which can cause compartment syndrome, especially when detected at a later stage. Herein, we report a rare case of compartment syndrome and skin necrosis due to extravasation, requiring emergency fasciotomy and skin graft in a 7-month-old boy who was treated with peripheral parenteral nutrition via a pressurized infusion pump. Although we cannot estimate the exact time at which extravasation occurred, the extent and degree of the wound suggest that the ischemic insult was prolonged, lasting for several hours. Pediatric clinicians and medical teams should carefully examine the site of insertion of the intravenous catheter, especially in patients receiving parenteral nutrition via a peripheral intravenous catheter with a pressurized infusion pump.

Extravasation Injury of Contrast Media in the Neck and Thorax During MDCT Scanning with 3D Image Reformation Findings (CT검사에서 조영제의 혈관외유출에 의한 목 및 흉부 손상의 3차원 재구성 영상)

  • Kweon, Dae-Cheol;Jang, Keun-Jo;Yoo, Beong-Gyu;Lee, Jong-Seok
    • Journal of radiological science and technology
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    • v.30 no.3
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    • pp.281-287
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    • 2007
  • Contrast media may cause tissue injury by extravasation during intravenous automated injection during CT examination. Here, we present a study in which contrast media extravasation was detected and localized in the neck and thorax by three-dimensional(3D) CT data reformation. The CT studies of the extavasation site were performed using a 3D software program with four different display techniques axial, multi planar reformation(MPR), maximum intensity projection(MIP), and volume rendering displays are currently available for reconstructing MDCT data. 3D image reconstructions provide accurate views of high-resolution imaging. This paper introduces extravasation with the MDCT and 3D reformation findings of contrast media extravasation in neck ant thorax. The followed injection of the external jugular vein into an existing intravenous catheter and a large volume of extravasation was demonstrated on by 3D MDCT.

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Subcutaneous Injection Contrast Media Extravasation: 3D CT Appearance (전산화단층검사에서 조영제의 피하 정맥 혈관외유출 환자의 3D영상)

  • Kweon Dae Cheol;Kim Tae Hyung;Yang Sung Hwan;Yoo Beong Gyu;Kim Myeong Goo;Park Peom
    • Progress in Medical Physics
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    • v.16 no.1
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    • pp.47-51
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    • 2005
  • We report a case of an accidental extravasation of contrast material. A large-volume extravasation occurred in an adult during spiral contrast-enhanced CT. The amount of contrast material extravasated was 47 ml. The patient had a swelling of the dorsum right hand. The extravasation injury site was determined by CT scanning. The extavasation case was examined using five separate display techniques: axial, multi planar reformation (MPR), maximum intensity projection (MIP), volume rendering, and shaded-surfaced display (SSD). This paper introduces extravasation with the CT and the three-dimensional appearance.

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Nurses' Knowledge and Performance for Prevention of Extravasation at Peripheral Intravenous Therapy (간호사 특성에 따른 일혈예방 지식과 간호수행)

  • Chung, Sun-A;Choi, Eun-Hee;Lee, Kyeong-Soo;Chung, Kwi-Ae
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.17 no.8
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    • pp.183-191
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    • 2016
  • This study was aimed to identify the level of knowledge and performance on nurses for the prevention of extravasation. Subjects of this study was 293 nurses working at three university hospitals, two general hospitals and one specialized hospital that frequently performed chemotherapy in D city. The highest score for the knowledge of nurses was extravasation drug related that it was $18.50{\pm}2.18$. The knowledge and performance were also higher for nurses with age greater than 50 years and married, with a clinical career of more than 10 years and high regard for extravasation. It is essential to develop other plans that promote the prevention of extravasation and to provide a continuous education for preventing extravasation. Therefore, it is necessary for medical institutes to operate patient safety management teams to develop standardized protocols and educating nurses and related persons.

CHANGES IN AUTONOMIC RESPONSES AND JAW MUSCLE ACTIVITY INDUCED BY TOOTH PULP STIMULATION IN THE RAT (쥐의 치수자극에 의해 유발되는 자율신경 반응과 악안면 근육활동의 변화)

  • Yu, Mi-Kyung;Park, Soo-Joung
    • Restorative Dentistry and Endodontics
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    • v.24 no.4
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    • pp.657-665
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    • 1999
  • The effects of application of mustard oil (MO), a small-fiber excitant and inflammatory irritant into the rat maxillary molar tooth pulp on arterial blood pressure and heat race, and electromyographic (EMG) activity of the jaw muscles were assessed in the anesthetized rats. In addition, Evans blue extravasation following pulpal MO application was measured. Application of MO into the tooth pulp produced a significant increase in mean arterial pressure and heat rate which gradually returned to baseline level. Application of MO into the tooth pulp induced a significant and short-lasting increase in EMG activity of digastric masseter and tongue muscle. Application of MO into the tooth pulp significantly increased the plasma extravasation of Evans blue dye. However, Application of mineral oil into the tooth pulp did not produce any significant changes in EMG activity of the digastric, masseter and tongue muscles, mean arterial pressure and heart rate, and plasma extravasation of Evans blue dye. These findings indicate that changes in arterial blood pressure, heart rate, jaw muscle activity and plasma extravasation accompanying noxious tooth pulp stimulation call be utilized as indirect measure of orofacial pain and inflammation.

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Compartment Syndrome of the Upper Extremity Induced by Extravasation of Contrast Media after Computed Tomography: A Case Report

  • Jung, Jae-Won;Lim, Young-Jae;Kim, Beom-Soo;Cho, Chul-Hyun
    • Clinics in Shoulder and Elbow
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    • v.20 no.4
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    • pp.240-243
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    • 2017
  • The incidence of contrast media extravasation has been increasing gradually. Most contrast media extravasations only can cause pain, swelling and erythema. However, in more severe cases, skin necrosis, ulceration, or compartment syndrome may occur, often necessitating a surgery. Early diagnosis and treatment should be established on the spot in order to avoid such a severe damage. We present a case of 42-year-old woman with a compartment syndrome in the right upper extremity caused by extravasation of computed tomography contrast media.

Extravasation from the Distal Anterior Choroidal Artery Aneurysm in Moyamoya Patient during Computed Tomographic Angiography

  • Chong, Jong-Yun;Yi, Hyeong-Joong;Kim, Kwang-Myung;Lee, Seung-Ro
    • Journal of Korean Neurosurgical Society
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    • v.41 no.5
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    • pp.340-342
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    • 2007
  • Three-dimensional computed tomographic angiography [CTA], a representative noninvasive radiologic technique, is being widely used for detecting vascular lesions in specific intracranial bleeding under a certain circumstance [acute nontraumatic subarachnoid hemorrhage]. We encountered a case of extravasation of the contrast medium on CTA images that appeared as ribbon-like high-attenuation lesion from an aneurysm at the distal anterior choroidal artery in a young adult moyamoya patient. As CTA is used more frequently, it is imperative to understand such unusual but, potentially lethal image findings to conduct a prompt intervention.

Unusual MR Features of Extravasation of Contrast Material in Hyperacute Intracerebral Hemorrhage (초급성 두개내 출혈 환자에서 조영제의 혈관외 누출을 동반한 비전형적 자기공명영상)

  • Choi Seung Hong;Chun Woo Sun;Kim Ji-Hoon;Kang Hyun Seung;Kwon Bae Ju;Na Dong Gyu;Kim Jae Hyung;Han Moon Hee;Chang Kee-Hyun
    • Investigative Magnetic Resonance Imaging
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    • v.9 no.1
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    • pp.50-56
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    • 2005
  • Contrast extravasation in hyperacute intracerebral hemorrhage (ICH) indicative of active bleeding is a predictor of possible enlargement of hematoma, providing clinician with valid management decisions. We report unusual MR imaging features of contrast extravasation in hyperacute ICH in three patients: Case 1 with hypertension revealed dual foci of contrast extravasation, one in right basal ganglia and the other in left lateral ventricle, suggesting simultaneous bleeding of the two foci. Case 2 with presumed diagnosis of vasculitis showed relatively large area of contrast extravasation mimicking enhancing tumor or vascular lesion. Case 3 with hypertension showed the findings of active bleeding which was likely to occur during the time of MR imaging acquisition.

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