Misplacement of piccs following power-injected CT contrast media

Peripherally inserted central catheters (PICCs) may be used to administer contrast injection during CT (computed tomography) scans to improve diagnostic accuracy. This is usually done with the use of a power injector. Research has shown that misplacement of catheters following contrast injection can occur. The aim of this review was to analyse appropriately positioned pre-scan PICCs that malposition following injection of contrast media during a CT scan, evaluate whether tip location or right or left insertion plays a part in the displacement of PICCs after CT, and to ensure those involved are aware of the risks and the safety checks required following such procedures. A quantitative method was used, gathering information from the team's insertion database to review 2045 records of contrast-injectable PICCs between 1 January 2015 and 30 April 2020. Analysis of the data indicated that 1% of appropriately sited PICCs malposition following contrast CT injection and that the catheter is able to self-correct back to its original position at an average interval of 24–72 hours without any other intervention. Further research is needed to explore other factors that could influence the rate of self-correction and complications of prolonged catheter malposition.

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MRI and CT contrast media extravasation

Medicine ◽

10.1097/md.0000000000010055 ◽

2018 ◽

Vol 97 (9) ◽

pp. e0055 ◽

Cited By ~ 16

Author(s):

Ashkan Heshmatzadeh Behzadi ◽

Zerwa Farooq ◽

Jeffery H. Newhouse ◽

Martin R. Prince

Keyword(s):

Contrast Media ◽

Ct Contrast

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Chapter-49 CT Contrast Media

Manual of Practical Physiology and MCQs Book ◽

10.5005/jp/books/12632_49 ◽

2015 ◽

pp. 439-442

Author(s):

Singh Hariqbal

Keyword(s):

Contrast Media ◽

Ct Contrast

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Power contrast injections through a totally implantable venous power port: A retrospective multicenter study

Phlebology The Journal of Venous Disease ◽

10.1177/0268355519863207 ◽

2019 ◽

Vol 35 (4) ◽

pp. 268-272 ◽

Cited By ~ 1

Author(s):

Ryong seong Son ◽

Yun Gyu Song ◽

Jeonghyun Jo ◽

Byeong-Ho Park ◽

Gyoo-sik Jung ◽

...

Keyword(s):

Computed Tomography ◽

Logistic Regression ◽

Regression Analysis ◽

Contrast Media ◽

Logistic Regression Analysis ◽

Computed Tomography Scan ◽

Power Injection ◽

Oncologic Patients ◽

Computed Tomography Scans ◽

Tomography Scan

Objectives To evaluate the feasibility and safety of power injection of contrast media through totally implantable venous power ports during computed tomography scans in oncologic patients. Methods The study population consisted of 417 patients who underwent computed tomography scan through a totally implantable venous power port. Clinical data were examined. Logistic regression analysis was used to assess the associations between clinical covariables and computed tomography scan failure. Results Successful computed tomography scans were achieved in 534 of 540 examinations (98.9%). Logistic regression analysis showed that contrast media above a 350 concentration was significantly associated with computed tomography scan failure (95% confidence interval: 1.01–1.13, p = 0.012). No major complications were noted. Conclusions Power injection of contrast media through a totally implantable venous power port for computed tomography examination is feasible and safe. This procedure provides an acceptable alternative in oncologic patients with inadequate peripheral intravenous access when computed tomography examination with contrast enhancement is needed.

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James Lean Body Weight Formula Is Not Appropriate for Determining CT Contrast Media Dose in Patients with High Body Mass Index

Radiology ◽

10.1148/radiol.2016152031 ◽

2016 ◽

Vol 278 (3) ◽

pp. 956-957 ◽

Cited By ~ 9

Author(s):

Ulf Nyman

Keyword(s):

Body Mass Index ◽

Body Weight ◽

Contrast Media ◽

Body Mass ◽

High Body Mass Index ◽

Lean Body Weight ◽

High Body ◽

Ct Contrast

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Advances in cardiac CT contrast injection and acquisition protocols

Cardiovascular Diagnosis and Therapy ◽

10.21037/cdt.2017.06.07 ◽

2017 ◽

Vol 7 (5) ◽

pp. 439-451 ◽

Cited By ~ 12

Author(s):

Jan-Erik Scholtz ◽

Brian Ghoshhajra

Keyword(s):

Cardiac Ct ◽

Contrast Injection ◽

Ct Contrast

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Contrast Media Extravasation: Manual versus Power Injector

Medical Principles and Practice ◽

10.1159/000083921 ◽

2005 ◽

Vol 14 (2) ◽

pp. 107-110 ◽

Cited By ~ 12

Author(s):

Tareq Sinan ◽

Hanaa Al-Khawari ◽

Fayaz A. Chishti ◽

Osama M. Al Saeed ◽

Mehraj Sheikh

Keyword(s):

Contrast Media ◽

Power Injector

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Is This Contrast? Is This Blood? An Agreement Study on Post-thrombectomy Computed Tomography Scans

Frontiers in Neurology ◽

10.3389/fneur.2020.593098 ◽

2020 ◽

Vol 11 ◽

Author(s):

Ronda Lun ◽

Gregory B. Walker ◽

Adrien Guenego ◽

Mohammed Kassab ◽

Eduardo Portela ◽

...

Keyword(s):

Computed Tomography ◽

Ct Scan ◽

Hemorrhagic Transformation ◽

Ct Scans ◽

Computed Tomography Scans ◽

Kappa Value ◽

Level Of Training ◽

Global Agreement ◽

Contrast Ct ◽

Agreement Study

Background: Hemorrhagic transformation after acute ischemic stroke is a dreaded and severe complication of thrombolysis and thrombectomy. However, its detection on post-thrombectomy conventional non-contrast computed tomography (CT) scan can be complicated by the frequent (and sometimes concomitant) presence of contrast, resulting in changes in management.Aims: Our objective was to assess the inter- and intra-rater reliability for the detection of blood and/or contrast on day-1 post-thrombectomy CT scans.Methods: A total of 18 raters across 3 different specialties independently examined 30 post-thrombectomy CT scans selected from the Aspiration vs. STEnt-Retriever (ASTER) trial. They were asked to judge the presence of blood and contrast. Thirty days later, the same 18 raters again independently judged the 30 scans, in randomized order. Agreement was measured with Fleiss' and Cohen's K statistics.Results: Overall agreement on blood and/ or contrast presence was only fair, k = 0.291 (95% CI = 0.273–0.309). There were 0 scans with consensus among the 18 readers on the presence of blood and/or contrast. However, intra-rater global agreement across all 18 physicians was relatively high, with a median kappa value of 0.675. This intra-rater consistency was seen across all specialties, regardless of level of training.Conclusion: Physician judgment for the presence of blood and/or contrast on day-1 post-thrombectomy non-contrast CT scan shows limited inter-observer reliability. Advanced imaging modalities may then be warranted for challenging clinical cases.

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Reduction of Malposition in Peripherally Inserted Central Catheters With Tip Location System

Journal of the Association for Vascular Access ◽

10.2309/java.12-1-8 ◽

2007 ◽

Vol 12 (1) ◽

pp. 29-31 ◽

Cited By ~ 11

Author(s):

Christine L. Naylor

Keyword(s):

Interventional Radiology ◽

Right Atrial ◽

Memorial Hospital ◽

Staff Satisfaction ◽

Common Occurrence ◽

Labor Costs ◽

Peripherally Inserted Central Catheters ◽

Catheter Malposition ◽

The Right ◽

Central Catheters

Abstract Catheter malposition is a common occurrence with the insertion of peripherally inserted central catheters (PICCs). Santa Rosa Memorial Hospital (SRMH) in Santa Rosa, California, trialed and implemented a new tip location device to evaluate whether malposition rates could be reduced. This article compares 6 months of data. Three of these months were compiled before using the tip locator device. The right atrial malposition rate remained consistent at 18% with or without the use of the tip locator device. All other malpositions were 13.4% without use of the tip locator. The overall malposition rate was 2.5% with the use of the tip locator device. By using this technology, supply and labor costs were reduced, as were referrals to interventional radiology and delays in treatment. Overall staff satisfaction improved.

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