Is a Surecan Safety II (port-a-cath) 22-gauge needle suitable for administering CT scan contrast media?

22-Gauge Port-a-Cath Needles Are NOT Recommended for CT Contrast Injection

A 22-gauge Surecan Safety II needle for port-a-cath access is inadequate for standard CT contrast protocols and should not be used for CT imaging requiring power injection. You need a minimum 20-gauge Huber needle for power-injectable ports, and even then, only if the port itself is specifically rated for high-pressure injection (≥325 psi). 1

Why 22-Gauge Is Insufficient

Flow Rate Requirements

• CT angiography protocols require 4-6 mL/s injection rates through 18-20 gauge or larger access to achieve adequate arterial enhancement (target 250 HU in pulmonary arteries). 1
• For pulmonary CT angiography specifically, guidelines recommend ≥20-gauge access with flow rates of 5 mL/s or higher. 1
• While 22-gauge peripheral catheters can theoretically achieve 5-8 mL/s in laboratory conditions, clinical application is limited to maximum 3 mL/s for contrast injection—well below what's needed for diagnostic CT. 1

Port Compatibility Issues

• Not all port-a-caths are CT power-injection compatible. Only ports specifically rated for 325 psi or higher can safely handle power injection. 1
• Using inadequate gauge needles or non-power-injectable ports risks catheter rupture, dislocation (reported incidence 2.2-15.4%), or suboptimal imaging. 2
• Studies using central venous catheters for contrast showed less contrast enhancement of pulmonary arteries and thoracic aorta when flow rates were inadequate. 2

The Correct Approach

Before Attempting Port Use

1. Verify the port is power-injection compatible (minimum 325 psi rating) by checking manufacturer specifications or port documentation. 1
2. Use only Huber-type needles (20-gauge or larger) to prevent damage to the port septum. 3, 1
3. Aspirate and discard blood to confirm patency, clear any heparin locks, and check for fibrin sleeve formation before injection. 1

Recommended Alternative (Preferred)

Place an 18-20 gauge peripheral IV in the antecubital fossa for the CT study. This is the preferred approach for optimal contrast delivery and avoids the complications and limitations of using port access. 3, 1

If You Must Use the Port

If peripheral access is truly impossible and the port is power-injectable:

• Use a 20-gauge or larger Huber needle (not 22-gauge). 1
• Consider higher concentration contrast media (350 mg I/mL vs 300 mg I/mL) to partially compensate for lower flow rates, though this remains suboptimal. 1
• Implement bolus tracking to ensure adequate enhancement, as timing will be less predictable. 2
• Follow a strict protocol including pressure monitoring during injection to prevent catheter complications. 4

Critical Pitfalls to Avoid

• Never assume a port is power-injectable without verification—using non-rated ports for power injection can cause catastrophic complications. 3, 1
• Do not use 22-gauge needles for CT contrast—the flow rate is insufficient for diagnostic imaging. 1
• Avoid using ports with fibrin sleeves or obstruction—these create extravasation risk. 3
• Do not proceed if you cannot achieve the required 4-6 mL/s flow rate—suboptimal contrast delivery results in non-diagnostic studies. 1