Computed tomography-guided pericardiocentesis: a systematic review concerning contemporary evidence and future perspectives

Vilela, Eduardo; Ruivo, Catarina; Guerreiro, Cláudio; Silva, Marisa P; Ladeiras-Lopes, Ricardo; Caeiro, Daniel; Morais, Gustavo Pires de; Primo, João; Braga, Pedro; Ferreira, Nuno; Nunes, José Pedro L.; Ribeiro, Vasco Gama

doi:10.1177/1753944718792413

Cited by 12 publications

(6 citation statements)

References 38 publications

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“…Our low rate of incomplete procedures, 6 (4.9%) cases, is in accordance with other published rates of CT-guided PCC between 0% and 6% 13,22 and rate of 5.9% reported for the procedure under US guidance. 21 In 2 cases, the procedure was attempted despite small effusion size, but we were unable to leave a catheter in place.…”

Section: Discussionsupporting

confidence: 92%

Therapeutic Computed Tomography–Guided Pericardiocentesis: Lessons Learned Based on a 7-Year Single-Center Experience

Khashper

Shelef

Taragin

et al. 2021

J Comput Assist Tomogr

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ObjectivePericardiocentesis is a well-known procedure commonly performed by either image-guided intervention or surgical approaches. Computed tomography (CT)–guided pericardiocentesis is not widely used, but provides certain advantages. In the article we will discuss our technique of CT-guided therapeutic pericardiocentesis, including advantages and disadvantages, patient selection, possible approaches, and complications.MethodsThe retrospective study included 121 therapeutic pericardial drainages performed under CT guidance. Demographic data of the patients, entry site, and needle orientation were recorded. Procedure complications and their significance were analyzed.ResultsOne hundred and twenty-one pericardial drainages with catheter insertion were performed under CT guidance on 119 patients presenting with clinically significant pericardial effusion. The most common approach was at the left anterior chest wall. The rate of minor complications was 5.8%, no major complications occurred.ConclusionsTherapeutic pericardiocentesis can be obtained under CT guidance in a safe and effective manner. Recommendations for building a patient-centered protocol with an interdisciplinary team are discussed. Patient selection, procedural guidance, and lessons to avoid complications are reviewed.

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Section: Discussionsupporting

confidence: 92%

Therapeutic Computed Tomography–Guided Pericardiocentesis: Lessons Learned Based on a 7-Year Single-Center Experience

Khashper

Shelef

Taragin

et al. 2021

J Comput Assist Tomogr

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“…In an era of multimodality imaging in cardiology, there has been substantial improvement in the application of pericardiocentesis. 4 , 5 , 6 , 7 Electrocardiogram‐guided 7 and CT‐guided 17 techniques have been described. Much of this improvement has been mainly through echocardiography with a high degree of success and a low level of complications.…”

Section: Discussionmentioning

confidence: 99%

“…However, it can be more complex in several types of patients, such as those recently submitted to cardiothoracic surgery, as well as those with poor echocardiographic acoustic windows. 12 , 21 , 22 CT‐guided pericardiocentesis 12 , 18 is also a valuable and practical option with the advantage of detailed three‐dimensional imaging, which allows the physician to better evaluate needle direction and tip positioning. It should be acknowledged, however, that the main limitations of CT are probably its availability and prolonged procedural durations, reported to be a median time of 65 min in one series.…”

Section: Discussionmentioning

confidence: 99%

High frequency ultrasound‐guided pericardiocentesis performed in the sitting position: A novel apical approach

Zhang

Liu

et al. 2021

Clinical Cardiology

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Background So far, few approaches have been described to reduce inadvertent injury to structure of the heart and nearby organs in percutaneous pericardiocentesis. Hypothesis We hypothesized that an in‐plane high frequency ultrasound‐guided apical approach, performed in the sitting position, would provide additional benefits in terms of feasibility and safety for draining malignant pericardial effusion (MPE). Methods The authors selected 53 consecutive patients with moderate or large symptomatic MPE who underwent high frequency ultrasound‐guided pericardiocentesis. After the procedure, all patients were followed for 90 days with the main purpose of detecting procedure success, procedure‐related complications, and recurrent PE. Results Procedure success rate for pericardiocentesis was 100%. All patients were placed in the sitting position with their left hands extended above the heads. An apical puncture approach was performed in all cases (100%). The mean duration of catheter drainage was 8.1 ± 3.2 days. The mean initial amount of pericardial fluid drained was 956.3 ± 687.5 ml. Overall, six patients (11%) had recurrent PE; 3 (6%) had repeated percutaneous pericardiocentesis. There was no major complication and minor complications occurred in four patients (8%). Conclusion This novel in‐plane high frequency US‐guided apical approach has several advantages for percutaneous pericardiocentesis of MPE: performed in the sitting position; a benefit for patients with orthopnea; a maximum inserted wide angle to prevent damage to the myocardium; local enlargement of the PE region; high procedure success rate of pericardiocentesis; and excellent clinical outcomes.

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“…10 CT guidance allows for technically successful drainage in 94 to 100% of patients with pericardial tamponade from pericardial effusions. 8,11,12 Additionally, there are few complications that have been reported, with most being self-limiting and occurring in 0 to 7.8% of patients. 8,11,[13][14][15][16][17][18] Complications include pneumothorax, pneumopericardium, myocardium, epicardial laceration, arrhythmia, and pericardial-pleural fistula.…”

Section: Review Of Outcomesmentioning

confidence: 99%

CT-Guided Pericardial Drainage: A Safe and Viable Alternative to Ultrasound-Guided Drainage

Ingber

Al-Roubaie

Lodhi

et al. 2022

Semin intervent Radiol

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Computed tomography-guided pericardiocentesis: a systematic review concerning contemporary evidence and future perspectives

Cited by 12 publications

References 38 publications

Therapeutic Computed Tomography–Guided Pericardiocentesis: Lessons Learned Based on a 7-Year Single-Center Experience

Therapeutic Computed Tomography–Guided Pericardiocentesis: Lessons Learned Based on a 7-Year Single-Center Experience

High frequency ultrasound‐guided pericardiocentesis performed in the sitting position: A novel apical approach

CT-Guided Pericardial Drainage: A Safe and Viable Alternative to Ultrasound-Guided Drainage

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