title: Safety and feasibility in highly concentrated contrast material power injections for CT-perfusion studies of the brain using central venous catheters.
abstract: BACKGROUND
  CT perfusion studies play an important role in the early detection as well as in therapy monitoring of vasospasm after subarachnoid hemorrhage. High-flow injections via central venous catheters are not recommended but may sometimes be the only possibility to obtain high-quality images.
  
  
  METHODS
  We retrospectively analyzed our data for CT perfusions performed with power injection of contrast material with an iodine concentration of 400mg/ml via the distal 16G lumen of the Arrow three and five lumen central venous catheter with preset flow rates of 5ml/s.
  
  
  RESULTS
  104 examinations with central venous catheters were evaluated (67 with five lumen and 37 with three lumen). No complications were observed. Mean flow rates were 4.4±0.5ml/s using the three lumen catheter and 4.6±0.6ml/s using the five lumen catheter respectively. The mean injection pressure measured by the power injector was 200.7±17.5psi for the three lumen central venous catheter and 194.5±6.5psi for the five lumen catheter, respectively.
  
  
  CONCLUSIONS
  Following a strict safety protocol there were no complications associated with power injections of contrast material containing 400mg iodine/ml with preset flow rates up to 5ml/s via the distal 16G lumen of the Arrow multi-lumen central venous catheter. However, since power-injections are off-label use with Arrow central venous catheters, this procedure cannot be recommended until potential safety hazards have been ruled out by the manufacturer.
authors: University Dusseldorf, Medical Faculty, Department of Diagnostic and Interventional Radiology, D-40225 Dusseldorf, Germany. stephan.macht@med.uni-duesseldorf.de
authors: Stephan
authors: S
authors: Macht
authors: Kerim
authors: K
authors: Beseoglu
authors: Sven
authors: S
authors: Eicker
authors: Konrad
authors: K
authors: Rybacki
authors: Sebastian
authors: S
authors: Braun
authors: Christian
authors: C
authors: Mathys
authors: Gerald
authors: G
authors: Antoch
authors: Bernd
authors: B
authors: Turowski