The modified squeeze maneuver for contrast medium extravasation: A radiological validation study

Aim: Contrast medium extravasation (CME) is an increasingly encountered complication of contrast-enhanced computed tomography, particularly with the widespread use of automatic pressure injectors. Although most cases resolve conservatively, severe events such as tissue necrosis and acute compartment syndrome may occur, and no standardized treatment algorithm exists. We evaluated the safety and effectiveness of a modified percutaneous squeeze maneuver designed to facilitate early contrast evacuation.Material and Methods: This retrospective case series included 18 adult patients with CME treated between 2019 and 2023. The technique consisted of multiple percutaneous punctures advanced to the fascial plane in a predefined geometric pattern, followed by controlled peripheral-to-central compression. Outcomes included radiologic clearance, pain reduction using the Visual Analog Scale (VAS), functional recovery using the Quick Disabilities of the Arm, Shoulder, and Hand (Quick-DASH) questionnaire at 6 months, and complications.Results: Radiologic clearance was observed in all included patients. Mean VAS scores decreased significantly from 7.11 ± 1.23 to 1.44 ± 0.92 after the intervention (Wilcoxon signed-rank test, p < 0.001). Functional outcomes were excellent, with a mean Quick-DASH score of 2.02 ± 4.33 and a median of 0. No procedure-related complications were observed.Conclusion: The modified squeeze maneuver is a simple, low-cost, and minimally invasive technique that provides rapid symptom relief, effective contrast evacuation, and excellent functional outcomes, representing a practical alternative between conservative observation and surgical intervention.