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C-0278 - Venous air embolism on head and neck CT: Location, frequency, significance and management.

N. Picazo Escribano1, L. Humanes López1, P. BARTUMEUS MARTINEZ1, M. Castro Copete2, R. Jimenez Yañez1; 1 ALICANTE/ES 2 Alicante/ES Type: Scientific Exhibit
Area of Interests: Emergency, Head and neck
Imaging Technique: CT
Procedures: Safety, Complications
Special Focuses: Embolism / Thrombosis, Patterns of Care
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Aims and objectives: Venous air embolism is a potentially catastrophic event that occurs as a consequence of the entry of air into the venous system, secondary to trauma and many medical and surgical procedures, especially those related to central venous catheterization and high-pressure infusion of intravenous fluids. [...]

Methods and materials: 500 consecutive head and neck CT scans with a 0,5-mm slice thickness (Aquilion One and Aquilion Prime, Toshiba), were retrospectively evaluated for gas in the venous system. 211 were neck contrast media enhanced CT (100 ml of xenetix 300 mg Iodo/ml), 214 were unenhanced brain scans and 75 were brain[...]

Results: Air emboli were present on 73 patients (14,6%) of 500 CT scans; on 47 enhanced neck CT and  25 brain CT (21 unenhanced and 4 enhanced). Air emboli occurred in 4 of 75 patients who underwent both unenhanced and contrast-enhanced CT. In one of these patients, air emboli were visible only on the [...]

Conclusion: Small amounts of air bubbles in the venous system are not an infrequent finding on head and neck CT scans, although when it occurs, generally is subclinical. Maybe small venous air embolism is an incidental finding on CT studies without consequences for the patient. As it is possible to find air b[...]

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References: 1- " Nonfatal venous air embolism after contrast-enhanced CT." John h. Woodrin,MD. Andrew M. Fried, MD. Radioloy 1988; 167: 405-407. 2- " Gas in the cavernous sinus". David Rubinstein and David Symonds. AJNR 15; 561-566, Mar 1994. 3- " Vascular air embolism: Location, Frequency and cause on electron[...]

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