Abstract
Background:Bleeding in the biopsy tract has been studied for its ability to decrease the risk of pneumothorax with indefinite results in the previous studies.Purpose:To investigate the risk factors for needle-tract bleeding (NTB) and the possible effect of NTB on the pneumothorax and resultant chest tube placement after CT-guided cutting needle biopsy (CT-CNB) of pulmonary lesions.Methods:Predictive variables for NTB and the effect of NTB on the development of pneumothorax and consequent chest tube placement were retrospectively determined in 416 patients who had undergone an 18-gauge non-coaxial CT-CNB (338 men and 78 women; average age, 59.3 years). Patient-related parameters were age, gender, patient position, and severity of pulmonary emphysema. Lesion-related variables were size, localization, and contour characteristics of the lesion. Procedure-related variables were the presence of atelectasis, pleural tag, and fissure in the needle-tract, length of the aerated lung parenchyma crossed by needle, needle entry angle, number of pleural punctures, the experience of the operator, and procedure duration. All variables were analyzed by x2 test and logistic regression analysis.Results:NTB was demonstrated in 142 of 421 (33.7%) procedures. The predictive variables of NTB were smaller lesion size (p = 0.011) and greater lesion depth (p = 0.002). In patients without emphysema around the lesion, the pneumothorax developed in 44/190 cases (23.1%) without NTB and in 12/95 procedures (12.6%) with NTB (p < 0.001).Conclusion:NTB may have a preventive effect on pneumothorax development, particularly in the absence of emphysema around the lesion.
Highlights
Computed tomography (CT)-guided core needle lung biopsy (CT-CNB) is a reliable and safe diagnostic procedure; the most common complication of CT-guided cutting needle biopsy (CT-CNB) is pneumothorax [1, 2]
We evaluated whether needle-tract bleeding (NTB) can function as a blood patch and prevent pneumothorax development and the resultant chest tube placement
The significant risk factors for NTB were identified as lesion size smaller than 3 cm (p < 0.001), greater lesion depth (p < 0.001), higher number of pleural passes (p = 0.008), and a needle entry angle < 75° (p = 0.007)
Summary
Computed tomography (CT)-guided core needle lung biopsy (CT-CNB) is a reliable and safe diagnostic procedure; the most common complication of CT-CNB is pneumothorax [1, 2] Some invasive techniques, such as injection of sealant materials (e.g., autologous blood patch, collagen plugs, fibrin glue, normal saline, hydrogel plugs) into the biopsy tract have been studied for their ability to decrease the risk of pneumothorax [3,4,5]. Purpose: To investigate the risk factors for needle-tract bleeding (NTB) and the possible effect of NTB on the pneumothorax and resultant chest tube placement after CT-guided cutting needle biopsy (CT-CNB) of pulmonary lesions. Methods: Predictive variables for NTB and the effect of NTB on the development of pneumothorax and consequent chest tube placement were retrospectively determined in 416 patients who had undergone an 18-gauge non-coaxial CT-CNB (338 men and 78 women; average age, 59.3 years). Conclusion: NTB may have a preventive effect on pneumothorax development, in the absence of emphysema around the lesion
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
