Safety evaluation of high pressure external jugular vein injection of iodine contrast material

Objective To evaluate the safety of high pressure injection of iodine contrast material into the external jugular vein.Methods 50 cases who accepted the CM injection via upper extremity veins were chosen as the control group,40 cases injected CM via external jugular vein were assigned to the observation group all of whose upper extremity veins were difficult to puncture.We designed an evaluation table to compare the two different high pressure vein injection methods,the observation indexes included:success rate of puncture,total time spend of puncture process,leakage ratio,dose of CM,injection speed,lag time,image quality,adverse effect incidence,heart rate and blood pressure changes before and after injection.Results There was 1puncture failure in the control group,the success rate of puncture was 98％ with no leakage cases.There was no puncture failure in the observation group except for two remaining needles slipped off after successful puncture.The variations of heart rate before and after puncture were[ (3.25 ± 11.53 ) beats/min vs( - 1.31±7.91) beats/min ],diastolic pressure[ ( - 6.75 ± 24.24 ) mm Hg vs( 3.04 ± 8.82 ) mm Hg ] in the control group and observation group,respectively,with no significant difference( t =1.59,- 1.91; both P ＞ 0.05 ).However,the changes of systolic pressure were[ ( - 2.60 ± 13.09 ) mm Hg vs ( 7.39 ± 13.52 ) mm Hg ],with statistically significant difference( t =- 2.52,P ＜ 0.05 ).No iodine contrast material related adverse effects happened in the two groups.The image quality were very high; Choosing external jugular vein puncture could improve the success rate of puncture,shorten the total time spend of puncture process and ease the pain of the patients,and the only added job was to adjust the dose of iodine contrast material and the lag time of screening.Conclusions Iodine injection via external jugular vein route is safe for patients with normal cardiac function,and it is an important method for those with poor vein condition. Key words: External jugular vein;  High pressure injection;  Iodine contrast;  Safety