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Case Reports
. 2018 Oct 6;14(1):41-43.
doi: 10.1016/j.radcr.2018.09.005. eCollection 2019 Jan.

Unintended intra-arterial injection of contrast of an intracranial CT angiography

Han Zhang  1 , Sumeet Kumar  1
Affiliations
Case Reports

Unintended intra-arterial injection of contrast of an intracranial CT angiography

Han Zhang et al. Radiol Case Rep. .

Abstract

Computed tomography angiography (CTA) is widely used to evaluate intracranial vascular disease. We report a case of intracranial CTA with unintended intra-arterial (IA) injection of contrast due to IA placement of an intravenous cannula, which results in a selective left vertebral artery IA CTA. Knowledge of anatomy is essential in analyzing the whole study and identifying the error. In clinical practice, it is important to avoid and recognize a wrongly placed intravenous cannula. And bolus tracking protocol might play a role as a gatekeeper.

Keywords: Computed tomography angiography; Intra-arterial injection.

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Figures

Fig. – 1
Fig. 1
“Arterial phase” of CTA showed enhancement of the left distal vertebral artery (arrow), left PICA territory, left cerebellar hemisphere, basilar artery, right AICA and SCA territories, and bilateral PCA territories.
Fig. – 2
Fig. 2
“Delayed phase” of CTA showed enhancement of all the arteries and veins, including bilateral vertebral arteries (arrows).
Fig. – 3
Fig. 3
Expected flow of contrast. Left upper limb IA injection (A); right upper limb IA injection with the reflux not strong enough to overcome the brachiocephalic trunk blood flow (B); right upper limb IA injection with the reflux strong enough to reach the aorta (C).
See this image and copyright information in PMC

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