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Randomized Controlled Trial
. 2023 Apr 11;23(1):54.
doi: 10.1186/s12880-023-01006-5.

Reduction of venous air embolism in coronary computed tomography angiography using a modified method of saline test injection

Weiling He  1 , Feng Huang  2 , An Xie  1 , Xiang Chen  1 , Wenjie Sun  1 , Rui Hu  3
Affiliations
Randomized Controlled Trial

Reduction of venous air embolism in coronary computed tomography angiography using a modified method of saline test injection

Weiling He et al. BMC Med Imaging. .

Abstract

Objectives: This paper analyzed the feasibility of reducing venous air emboli introduced during tube connection in computed tomography angiography (CTA) through a modified method of saline test injection.

Methods: A total of 386 cases of patients undergoing coronary CTA examination were randomly arranged into a control group (199 patients underwent conventional saline injection before the CTA examination) and a case group (187 patients underwent modified saline injection before the CTA examination). The two groups were compared for the location (Fisher's exact test), number (χ2 test), and diameter (Mann-Whitney rank sum test) of the air emboli along the inflow direction of contrast agent within the scan.

Results: The occurrence rate was 10.55% in the control group and 3.74% in the case group respectively, with a statistically different significance (P = 0.010). In the case group, there were 7 cases of small-grade venous air emboli. In the control group, there were 15 cases of small-grade venous air emboli and 6 cases of moderate-grade venous air emboli. No cases of large-grade venous air emboli were found in both groups.

Conclusions: The use of this modified method of saline test injection before CTA examination is able to effectively decrease the occurrence of venous air emboli introduced during tube connection, which has some certain practical significance.

Keywords: A modified method of saline test injection; Computed tomography; Contrast agent; Coronary computed tomography angiography; Venous air embolus.

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Conflict of interest statement

The authors report no relationships that could be construed as a conflict of interest.

Figures

Fig. 1
Fig. 1
Inclusion and exclusion criteria
Fig. 2
Fig. 2
Diagram for the conventional saline test injection Notes: ① The high-pressure injector; ② The external tube of the high-pressure injector; ③ The connection between the external tube and the disposable pressure extension tube of the high-pressure injector; ④ The disposable pressure extension tube; ⑤ The connection between the disposable pressure extension tube and the Y-type indwelling needle; ⑥ The unconnected outlet of the Y-type indwelling needle; ⑦ The clipping switch for the Y-type indwelling needle; ⑧ The entry of the Y-type indwelling needle into the human body. In the conventional saline test injection, the injection can be conducted after connection in ③ and the open of the clip switch in ⑦
Fig. 3
Fig. 3
Diagram for the modified saline test injection Notes: ① The high-pressure injector; ② The external tube of the high-pressure injector; ③ The connection between the external tube and the disposable pressure extension tube of the high-pressure injector; ④ The disposable pressure extension tube; ⑤ The connection between the disposable pressure extension tube and the Y-type indwelling needle; ⑥ The unconnected outlet of the Y-type indwelling needle; ⑦ The clipping switch for the Y-type indwelling needle; ⑧ The entry of the Y-type indwelling needle into the human body; ⑨ The three joint design of the Y-type indwelling needle utilized for liquid drainage out of the unconnected outlet. In the modified saline test injection, the injection can be conducted after connection in ③, the close of the clip switch in ⑦, the open of the unconnected outlet in ⑥, and the operation in ⑨
Fig. 4
Fig. 4
Representative patients Notes: ① A bubble-shaped air embolus in the right atrium (arrow) as shown by CCTA examination; ② A bubble-shaped air embolus in the right ventricle (arrow) as shown by CCTA examination; ③ A bubble-shaped air embolus in the main pulmonary artery (arrow) as shown by CCTA examination; ④ A bubble-shaped air embolus in the superior vena cava (arrow) as shown by CCTA examination. CCTA, coronary computed tomography angiography
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