title: Successful computed tomography angiogram through tibial intraosseous access: a case report.
abstract: BACKGROUND
  Intraosseous access has been used increasingly with proven efficacy in emergent situations for adults when intravenous access could not be obtained.
  
  
  OBJECTIVE
  Our aim was to demonstrate if tibial intraosseous (IO) is an effective route for iodinated contrast administration and pulmonary vasculature visualization.
  
  
  METHODS
  We report on an obtunded patient requiring a computed tomography angiogram to help with diagnosis and tibial IO was the only viable access appropriate to withstand the pressure of a computed tomography iodinated contrast load. Tibial IO access was used successfully for administration of iodinated contrast to evaluate for massive pulmonary embolism in an obtunded patient in extremis secondary to cardiovascular instability.
  
  
  CONCLUSIONS
  The pulmonary arteries were opacified and demonstrated a high-quality CT angiogram can be done via tibial IO device.
authors.affiliation: Department of Emergency Medicine, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin 53792, USA.
authors.forename: Kerry L
authors.initials: KL
authors.lastname: Ahrens
authors.forename: Scott B
authors.initials: SB
authors.lastname: Reeder
authors.forename: Jon G
authors.initials: JG
authors.lastname: Keevil
authors.forename: Janis P
authors.initials: JP
authors.lastname: Tupesis
mesh_terms: D000792:Angiography / Q000379:methods*; D003287:Contrast Media / Q000008:administration & dosage; D006801:Humans; D017148:Infusions, Intraosseous / Q000379:methods*; D007455:Iodine / Q000008:administration & dosage; D008297:Male; D008875:Middle Aged; D011655:Pulmonary Embolism / Q000000981:diagnostic imaging*; D013977:Tibia; D014057:Tomography, X-Ray Computed / Q000379:methods*
chemical_list: D003287:Contrast Media; D007455:Iodine
keywords: CT angiogram; diagnostic imaging; intraosseous access; iodinated contrast; pulmonary vasculature