Is the BioSentry Tract Sealant System Effective in Reducing the Pneumothorax Rate After CT-Guided Transthoracic Lung Biopsy With an 18G Biopsy Needle?

Abstract

This study evaluated whether the BioSentry Tract Sealant System (BTS) (Merit Medical Systems, South Jordan, Utah) reduces pneumothorax rates in CT-guided lung biopsies (CTLB) using an 18G biopsy/17G introducer needle. A total of 272 patients underwent CTLB between January 2015 and February 2019 using a 17G/18G system. BTS was used in 125 patients, while no pleural sealant was used in 147. The variables assessed included pneumothorax on post-biopsy CT images or chest X-ray, chest tube insertion, lesion size, pleura-to-lesion distance, and the presence of emphysema. The two groups were compared using T-tests with a significance level of 0.05. In the BTS group, 23 subjects (18%) had a pneumothorax compared to 38 (26%) in the control group (p < 0.05). Four patients (17%) in the BTS group required a chest tube, compared to three patients (8%) in the control group (p = 0.28). The mean lesion size in patients with a pneumothorax was 1.62 cm in the BTS group and 2.44 cm in the control group (p = 0.27). The mean pleura-to-lesion distance in those with pneumothorax was 2.23 cm in the BTS group and 1.52 cm in the control group (p = 0.17). Emphysema was present in 47% of patients in the BTS group and 30% in the control group (p < 0.05). BTS reduced pneumothorax rates in CTLB patients using a 17G/18G system, despite a higher proportion of emphysema patients in the BTS group. No significant difference in the rate of chest tube insertion was observed with or without BTS, which contrasts with previous studies where 19G/20G biopsy systems were used.