Is it safe to inject contrast through the side arm of an introducer sheath? An in vitro study.

Purpose: Occasionally, a patient requiring computed tomography (CT) with poor venous access or in an unstable condition may have a sheath as their only form of IV access. Many institutions prohibit contrast power injection through the side ports, for concern for rupture. We hypothesize that under conditions encountered in CT scanning, the side arm of the sheath introducer is safe for power injection of contrast material.
Methods: In this in vitro study, we injected contrast at different flow rates varying from 2 to 8 ml/s, through the side port of the sheath. Time-pressure graphs were obtained for each injection from the injector display. The assembly was observed for any signs of leakage or material failure.
Results: There was not a single event of leak, rupture, or displacement. Maximum pressures were within the range of conventional contrast administrations.
Conclusion: This study suggests that iodinated contrast can safely be injected through the side port of a venous sheath.