{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T06:03:27Z","timestamp":1788242607387,"version":"build-2803163510"},"reference-count":0,"publisher":"Georg Thieme Verlag KG","issue":"01","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Fortschr R\u00f6ntgenstr"],"published-print":{"date-parts":[[2019,1]]},"abstract":"<jats:p>\n            Background\u2002Contrast extravasation events in daily radiological routine may lead to serious complications, especially during CT examinations. The resulting symptoms may vary from local pain up to skin ulcers, necrosis or even acute compartment syndrome.<\/jats:p><jats:p>There are no uniformly accepted radiological guidelines or recommendations regarding detection and treatment of extravasation events and immanent complications in a timely manner.<\/jats:p><jats:p>\n            Method\u2002Systematic literature research considering the last 35 years via PubMed using search terms \u201ccontrast medium extravasation\/paravasation\u201d.<\/jats:p><jats:p>\n            Results\u2002In the literature, there are conservative management approaches of contrast media extravasation without major evidence base, such as unguent dressings, cooling or splinting. This therapy is mostly symptomatic. Additionally, various invasive techniques are described. We discuss these techniques in the context of contemporary literature, such as the hyaluronidase Injection into the site of extravasation, suction\/aspiration technique including flushing of the affected tissue areas and the squeezing technique. However, most citations lack scientific evidence: many articles include anecdotal enumerations, case studies or cite publications from the era, when ionic high osmolar contrast media was state-of-the-art. Besides, many authors derive their extravasation management from studies, where agents other than contrast media were investigated.<\/jats:p><jats:p>\n            Conclusion\u2002After detailed literature review, we suggest early (plastic) surgical consultation when non-ionic, low-osmolar contrast medium extravasation is about 150\u200acc or more. In case of extravasation less than 150\u200acc but in presence of additional symptoms such as impaired perfusion or altered sensibility, the (plastic) surgeon should also be consulted instantly. We do not recommend any invasive first line therapy when contrast media extravasation is less than 150\u200acc and the patient presents no additional symptoms, besides swelling and local pain. Nevertheless continuous monitoring and accurate conservative management such as active cooling and elevation, splinting of the affected extremity are mandatory as early detection of critical symptoms helps to initiate prompt surgical intervention and avoid sequelae.<\/jats:p><jats:p>\n            Key Points\u2002<\/jats:p><jats:p>\n            Citation Format\n          <\/jats:p>","DOI":"10.1055\/a-0628-7095","type":"journal-article","created":{"date-parts":[[2018,6,18]],"date-time":"2018-06-18T23:05:56Z","timestamp":1529363156000},"page":"25-32","source":"Crossref","is-referenced-by-count":16,"title":["Contrast Media Extravasation in CT and MRI \u2013 A Literature Review\u00a0and Strategies for Therapy"],"prefix":"10.1055","volume":"191","author":[{"given":"Veronika","family":"Mandlik","sequence":"additional","affiliation":[{"name":"Center of Plastic-, Hand- and Reconstructive Surgery, University Hospital Regensburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lukas","family":"Prantl","sequence":"additional","affiliation":[{"name":"Center of Plastic-, Hand- and Reconstructive Surgery, University Hospital Regensburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andreas","family":"Schreyer","sequence":"additional","affiliation":[{"name":"Department of Radiology, University Hospital Regensburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"194","published-online":{"date-parts":[[2018,6,18]]},"container-title":["R\u00f6Fo - Fortschritte auf dem Gebiet der R\u00f6ntgenstrahlen und der bildgebenden Verfahren"],"original-title":[],"language":"de","link":[{"URL":"http:\/\/www.thieme-connect.de\/products\/ejournals\/pdf\/10.1055\/a-0628-7095.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2019,2,4]],"date-time":"2019-02-04T10:12:21Z","timestamp":1549275141000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.thieme-connect.de\/DOI\/DOI?10.1055\/a-0628-7095"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2018,6,18]]},"references-count":0,"journal-issue":{"issue":"01","published-online":{"date-parts":[[2018,12,13]]},"published-print":{"date-parts":[[2019,1]]}},"URL":"https:\/\/doi.org\/10.1055\/a-0628-7095","relation":{},"ISSN":["1438-9029","1438-9010"],"issn-type":[{"value":"1438-9029","type":"print"},{"value":"1438-9010","type":"electronic"}],"subject":[],"published":{"date-parts":[[2018,6,18]]}}}