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Roditi G, Khan N, van der Molen AJ, Bellin MF, Bertolotto M, Brismar T, Correas JM, Dekkers IA, Geenen RWF, Heinz-Peer G, Mahnken AH, Quattrocchi CC, Radbruch A, Reimer P, Romanini L, Stacul F, Thomsen HS, Clément O. Intravenous contrast medium extravasation: systematic review and updated ESUR Contrast Media Safety Committee Guidelines. Eur Radiol 2022; 32:3056-3066. [PMID: 35175378 PMCID: PMC9038843 DOI: 10.1007/s00330-021-08433-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2021] [Revised: 08/29/2021] [Accepted: 10/14/2021] [Indexed: 01/28/2023]
Abstract
NEED FOR A REVIEW Guidelines for management and prevention of contrast media extravasation have not been updated recently. In view of emerging research and changing working practices, this review aims to inform update on the current guidelines. AREAS COVERED In this paper, we review the literature pertaining to the pathophysiology, diagnosis, risk factors and treatments of contrast media extravasation. A suggested protocol and guidelines are recommended based upon the available literature. KEY POINTS • Risk of extravasation is dependent on scanning technique and patient risk factors. • Diagnosis is mostly clinical, and outcomes are mostly favourable. • Referral to surgery should be based on clinical severity rather than extravasated volume.
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Affiliation(s)
- Giles Roditi
- Department of Radiology, Glasgow Royal Infirmary, Glasgow, UK
| | - Nadir Khan
- Department of Radiology, Glasgow Royal Infirmary, Glasgow, UK
| | - Aart J van der Molen
- Department of Radiology, Leiden University Medical Center, Leiden, The Netherlands
| | - Marie-France Bellin
- University Paris-Saclay, AP-HP, University Hospital Bicêtre, Service de Radiologie, BioMaps, Le Kremlin-Bicêtre, France
| | | | - Torkel Brismar
- Department of Clinical Science, Intervention and Technology, Unit of Radiology, Karolinska Institutet and Department of Radiology, Karolinska University Hospital in Huddinge, Stockholm, Sweden
| | - Jean-Michel Correas
- Université de Paris, AP-HP, Groupe Hospitalier Necker, DMU Imagina, Service de Radiologie, Paris, France
| | - Ilona A Dekkers
- Department of Radiology, Leiden University Medical Center, Leiden, The Netherlands
| | - Remy W F Geenen
- Department of Radiology, Northwest Clinics, Alkmaar, The Netherlands
| | | | - Andreas H Mahnken
- Department of Diagnostic and Interventional Radiology, Marburg University Hospital, Marburg, Germany
| | - Carlo C Quattrocchi
- Imaging Center, Unit of Diagnostic Imaging and Interventional Radiology, Università Campus Bio-Medico Di Roma, Rome, Italy
| | - Alexander Radbruch
- Department of Radiology, Clinic for Diagnostic and Interventional Neuroradiology, Bonn, Germany
| | - Peter Reimer
- Department of Radiology, Institute for Diagnostic and Interventional Radiology, Klinikum Karlsruhe, Karlsruhe, Germany
| | | | - Fulvio Stacul
- Department of Radiology, Ospedale Maggiore, Trieste, Italy
| | - Henrik S Thomsen
- Department of Radiology, Copenhagen University Hospital Herlev, Copenhagen, Denmark
| | - Olivier Clément
- Université de Paris, AP-HP, Hôpital Européen Georges Pompidou, DMU Imagina, Service de Radiologie, 20 Rue LeBlanc, 75015, Paris, France.
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Hrycyk J, Heverhagen JT, Boehm I. What you should know about prophylaxis and treatment of radiographic and magnetic resonance contrast medium extravasation. Acta Radiol 2019; 60:496-500. [PMID: 29896979 DOI: 10.1177/0284185118782000] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
In addition to anaphylactic reactions induced by contrast media (CM), extravasation is an adverse reaction that occurs immediately, requires special treatment, and attention. Since radiologists are often not familiar with either prophylactic or treatment modalities, the goal of this paper is to summarize the major facts and recommendations with respect to CM extravasation under practical clinical aspects.
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Affiliation(s)
- Joris Hrycyk
- Department of Diagnostic, Interventional, and Pediatric Radiology, Inselspital, University Hospital, University of Bern, Bern, Switzerland
| | - Johannes T Heverhagen
- Department of Diagnostic, Interventional, and Pediatric Radiology, Inselspital, University Hospital, University of Bern, Bern, Switzerland
| | - Ingrid Boehm
- Department of Diagnostic, Interventional, and Pediatric Radiology, Inselspital, University Hospital, University of Bern, Bern, Switzerland
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