title: Selection of peripheral intravenous catheters with 24-gauge side-holes versus those with 22-gauge end-hole for MDCT: A prospective randomized study.
abstract: OBJECTIVE
  To compare the 24-gauge side-holes catheter and conventional 22-gauge end-hole catheter in terms of safety, injection pressure, and contrast enhancement on multi-detector computed tomography (MDCT).
  
  
  METHODS
  In a randomized single-center study, 180 patients were randomized to either the 24-gauge side-holes catheter or the 22-gauge end-hole catheter groups. The primary endpoint was safety during intravenous administration of contrast material for MDCT, using a non-inferiority analysis (lower limit 95% CI greater than -10% non-inferiority margin for the group difference). The secondary endpoints were injection pressure and contrast enhancement.
  
  
  RESULTS
  A total of 174 patients were analyzed for safety during intravenous contrast material administration for MDCT. The overall extravasation rate was 1.1% (2/174 patients); 1 (1.2%) minor episode occurred in the 24-gauge side-holes catheter group and 1 (1.1%) in the 22-gauge end-hole catheter group (difference: 0.1%, 95% CI: -3.17% to 3.28%, non-inferiority P=1). The mean maximum pressure was higher with the 24-gauge side-holes catheter than with the 22-gauge end-hole catheter (8.16±0.95kg/cm2vs. 4.79±0.63kg/cm2, P<0.001). The mean contrast enhancement of the abdominal aorta, celiac artery, superior mesenteric artery, and pancreatic parenchyma in the two groups were not significantly different.
  
  
  CONCLUSIONS
  In conclusion, our study showed that the 24-gauge side-holes catheter is safe and suitable for delivering iodine with a concentration of 300mg/mL at a flow-rate of 3mL/s, and it may contribute to the care of some patients, such as patients who have fragile and small veins. (Trial registration: UMIN000023727).
authors.affiliation: Department of Radiology, Iwate Medical University School of Medicine, 19-1 Uchimaru, Morioka 020-8505, Japan. Electronic address: a.akahane@gmail.com.
authors.forename: Akio
authors.initials: A
authors.lastname: Tamura
authors.affiliation: Department of Radiology, Iwate Medical University School of Medicine, 19-1 Uchimaru, Morioka 020-8505, Japan. Electronic address: kkato@iwate-med.ac.jp.
authors.forename: Kenichi
authors.initials: K
authors.lastname: Kato
authors.affiliation: Iwate Medical University Hospital, 19-1 Uchimaru, Morioka 020-8505, Japan. Electronic address: kamataaoi@yahoo.co.jp.
authors.forename: Masayoshi
authors.initials: M
authors.lastname: Kamata
authors.affiliation: Department of Radiology, Iwate Medical University School of Medicine, 19-1 Uchimaru, Morioka 020-8505, Japan. Electronic address: suzukitomohiro123@gmail.com.
authors.forename: Tomohiro
authors.initials: T
authors.lastname: Suzuki
authors.affiliation: Department of Radiology, Iwate Medical University School of Medicine, 19-1 Uchimaru, Morioka 020-8505, Japan. Electronic address: mamimichiko@me.com.
authors.forename: Michiko
authors.initials: M
authors.lastname: Suzuki
authors.affiliation: Department of Radiology, Iwate Medical University School of Medicine, 19-1 Uchimaru, Morioka 020-8505, Japan. Electronic address: gakuymgt@yahoo.co.jp.
authors.forename: Manabu
authors.initials: M
authors.lastname: Nakayama
authors.affiliation: Department of Radiology, Iwate Medical University School of Medicine, 19-1 Uchimaru, Morioka 020-8505, Japan. Electronic address: mtomabechi@mac.com.
authors.forename: Makiko
authors.initials: M
authors.lastname: Tomabechi
authors.affiliation: Department of Radiology, Southern Tohoku Research Institute for Neuroscience, 7-115 Yatsuyamada, Koriyama 963-8563, Japan. Electronic address: nakasato77@gmail.com.
authors.forename: Tatsuhiko
authors.initials: T
authors.lastname: Nakasato
authors.affiliation: Department of Radiology, Iwate Medical University School of Medicine, 19-1 Uchimaru, Morioka 020-8505, Japan. Electronic address: ehara@iwate-med.ac.jp.
authors.forename: Shigeru
authors.initials: S
authors.lastname: Ehara
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002406:Catheterization, Peripheral / Q000295:instrumentation* / Q000379:methods; D003287:Contrast Media / Q000008:administration & dosage*; D005260:Female; D006801:Humans; D007275:Injections, Intravenous / Q000295:instrumentation / Q000379:methods; D007472:Iohexol / Q000008:administration & dosage; D008297:Male; D008875:Middle Aged; D061330:Multidetector Computed Tomography / Q000379:methods*; D011446:Prospective Studies; D011856:Radiographic Image Enhancement / Q000295:instrumentation / Q000379:methods*; D055815:Young Adult
chemical_list: D003287:Contrast Media; D007472:Iohexol
keywords: Access site complication; Contrast media; Extravasation; Multi-detector computed tomography