Air embolus risk with glass versus plastic syringes: In vitro study and implications for neuroangiography

PURPOSE: To assess syringe use among neuroangiographers and evaluate air emboli produced with glass and plastic syringes. MATERIALS AND METHODS: Questionnaires on syringe use were sent to 100 members of the American Society of Neuroradiology (ASNR). An in vitro system counted emboli during injections of contrast material and saline solution with either glass or plastic syringes. At Doppler sonography, an embolic signal was defined as the power of the reflected amplitude with auditory and visual confirmation. RESULTS: Of 62 respondents, 11.3% used glass syringes exclusively and 80.6% used plastic exclusively. Glass breakage was experienced by 72.5%, and 40% of them recalled an injury associated with such a breakage. No statistically significant difference was found between glass and plastic syringes for introduction of air emboli, though two outlying values represented larger numbers of emboli in the group with plastic syringes and contrast material. CONCLUSION: No reason for the continued use of glass syringes was found. No statistically greater risk of air emboli was shown with plastic syringes, and risk of breakage and injury is prevented. Caution is advised when injecting contrast material with plastic syringes because more air emboli may be introduced.