Canadian Association of Radiologists/Canadian Association for Interventional Radiology/Canadian Society of Thoracic Radiology Guidelines on Thoracic Interventions

Nguyen, Elsie T.; Bayanati, Hamid; Hurrell, Casey; Aitken, Matthew; Cheung, Edward M.; Gupta, Ashish; Harris, Scott R.; Sedlic, T.; Taylor, Jana; Gahide, G.; Dennie, Carole

doi:10.1177/08465371221122807

Cited by 5 publications

(5 citation statements)

References 99 publications

(133 reference statements)

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“…It is widely recognized that the physician experience and the use of imaging guidance reduce the rate of post-procedural complications [ 12 , 23 ]. Between the possible complications, the most common one is pneumothorax [ 43 ]. The pathophysiology of post-aspiration pneumothorax is likely multifactorial; indeed, some cases are caused by direct lung injury or the introduction of air during the procedure.…”

Section: Complicationsmentioning

confidence: 99%

“…The pathophysiology of post-aspiration pneumothorax is likely multifactorial; indeed, some cases are caused by direct lung injury or the introduction of air during the procedure. In other cases, it seems reasonable to affirm that the aspiration of fluid in an unexpandable lung (i.e., for malignant parenchymal lung disease) could produce a significantly low pressure in the pleural space determining an ex vacuo pneumothorax [ 43 , 44 ]. The mechanism by which this damage is generated is not fully known but seems to be related to this “trapped lung” [ 43 ].…”

Section: Complicationsmentioning

confidence: 99%

“…In other cases, it seems reasonable to affirm that the aspiration of fluid in an unexpandable lung (i.e., for malignant parenchymal lung disease) could produce a significantly low pressure in the pleural space determining an ex vacuo pneumothorax [ 43 , 44 ]. The mechanism by which this damage is generated is not fully known but seems to be related to this “trapped lung” [ 43 ]. This uncommon phenomenon is characterized by the introduction of air into the pleural space, a consequence of a vacuum-like negative intrapleural pressure stemming from lung collapse [ 45 ].…”

Section: Complicationsmentioning

confidence: 99%

See 2 more Smart Citations

Ultrasound-Assisted and Ultrasound-Guided Thoracentesis: An Educational Review

Boccatonda,

Baldini,

Rampoldi

et al. 2024

Diagnostics

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Thoracentesis is one of the most important invasive procedures in the clinical setting. Particularly, thoracentesis can be relevant in the evaluation of a new diagnosed pleural effusion, thus allowing for the collection of pleural fluid so that laboratory tests essential to establish a diagnosis can be performed. Furthermore, thoracentesis is a maneuver that can have therapeutic and palliative purposes. Historically, the procedure was performed based on a physical examination. In recent years, the role of ultrasound has been established as a valuable tool for assistance and guidance in the thoracentesis procedure. The use of ultrasound increases success rates and significantly reduces complications. The aim of this educational review is to provide a detailed and sequential examination of the procedure, focusing on the two main modalities, the ultrasound-assisted and ultrasound-guided form.

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Section: Complicationsmentioning

confidence: 99%

Section: Complicationsmentioning

confidence: 99%

Section: Complicationsmentioning

confidence: 99%

See 1 more Smart Citation

Ultrasound-Assisted and Ultrasound-Guided Thoracentesis: An Educational Review

Boccatonda,

Baldini,

Rampoldi

et al. 2024

Diagnostics

View full text Add to dashboard Cite

show abstract

“…Emphysema is markedly associated with the incidence of pneumothorax after PTLB [ 9 ], and the incidence rates of pneumothorax and chest tube placement after PTLB are substantially higher in patients with emphysema than in those without emphysema (41.1% vs. 24.3%) and (27.2% vs. 8.8%, respectively). Tract embolization has been recommended as a preventive measure for pneumothorax according to relevant guidelines [ 10 ]. Current methods to prevent PTLB-induced pneumothorax include injection of autologous blood patches [ 11 – 14 ], NaCl 0.9% solution [ 15 ], hydrogel plugs [ 16 , 17 ], and gelatin sponge particle slurry [ 18 – 21 ].…”

Section: Introductionmentioning

confidence: 99%

Safety and efficacy of tract embolization using gelatin sponge particles in reducing pneumothorax after CT-guided percutaneous lung biopsy in patients with emphysema

Yang,

Cheng,

Huang

et al. 2024

BMC Pulm Med

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Background The incidence of pneumothorax is higher in patients with emphysema who undergo percutaneous lung biopsy. Needle embolization has been shown to reduce the incidence of pneumothorax in patients with emphysema. Existing studies have reported small sample sizes of patients with emphysema, or the degree of emphysema has not been graded. Therefore, the efficacy of biopsy embolization in the prevention of pneumothorax induced by percutaneous pulmonary biopsy in patients with emphysema remains to be determined. Methods In this retrospective, controlled study, patients with emphysema who underwent CT-guided PTLB were divided into two groups: group A (n = 523), without tract embolization, and Group B (n = 504), with tract embolization. Clinical and imaging features were collected from electronic medical records and Picture Archiving and Communication Systems. Univariate and multivariate analyses were performed to identify risk factors for pneumothorax and chest tube placement. Results The two groups did not differ significantly in terms of demographic characteristics and complications other than pneumothorax. The incidence of pneumothorax and chest tube placement in group B was significantly lower than in group A (20.36% vs. 46.12%, p < 0.001; 3.95% vs. 9.18%, p < 0.001, respectively). In logistic regression analyses, variables affecting the incidence of pneumothorax and chest tube placement were the length of puncture of the lung parenchyma (odds ratio [OR] = 1.18, 95% confidence interval [CI]: 1.07–1.30, p = 0.001; OR = 1.55, 95% CI: 1.30–1.85, p < 0.001, respectively), tract embolization (OR = 0.31, 95% CI: 0.24–0.41, p < 0.001; OR = 0.39, 95% CI: 0.22–0.69, p = 0.001, respectively), and grade of emphysema. Conclusions Tract embolization with gelatin sponge particles after CT-guided PTLB significantly reduced the incidence of pneumothorax and chest tube placement in patients with emphysema. Tract embolization, length of puncture of the lung parenchyma, and grade of emphysema were independent risk factors for pneumothorax and chest tube placement. Trial registration Retrospectively registered.

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“…In addition to examining the procedure’s complications, these studies [ 25 , 27 , 28 ] uncovered comparable complication rates across various ablation techniques for lung tumors. It is well known that complication rate of CT guided intervention is directly associated with needle size [ 29 ]. However, the potential impact of using different needle sizes (ranging from 13 to 17 gauge) in these trials has not been sufficiently addressed in terms of evaluating complications and treatment response [ 25 , 27 , 28 , 30 ].…”

Section: Introductionmentioning

confidence: 99%

The safety and response of CT guided percutaneous cryoablation for lung nodules by 17-gauge needles

Lin,

Chen,

Yim

et al. 2023

BMC Med Imaging

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Background The safety and efficacy of 17-gauge needles used in CT-guided percutaneous cryoablation for lung nodules were explored in this study. The purpose of the study was to compare the findings with earlier research and multi-center clinical trials that used various needle sizes. Methods Between 2016 and 2020, a retrospective study was conducted with approval from the institutional review board. A total of 41 patients were enrolled, and 71 lung nodules were treated in 63 cryoablation procedures using local anesthesia. Complication rates were recorded, and overall survival rates as well as tumor progression-free rates were calculated using the Kaplan-Meier method. Results Self-limited hemoptysis was caused by 12.9% of the procedures, and drainage was required for pneumothoraces resulting from 11.3% of them. The overall survival rates at one, two, three, and four years were 97%, 94%, 82%, and 67%, respectively. The tumor progression-free rates at one, two, three, and four years were 86.2%, 77%, 74%, and 65%, respectively. Conclusion Cryoablation for lung nodules using 17-Gauge needles can achieve similar rates of survival and tumor control rates, similar or even lower complication rates as compared with other studies and multi-center trials using mixed sized needles.

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Canadian Association of Radiologists/Canadian Association for Interventional Radiology/Canadian Society of Thoracic Radiology Guidelines on Thoracic Interventions

Cited by 5 publications

References 99 publications

Ultrasound-Assisted and Ultrasound-Guided Thoracentesis: An Educational Review

Ultrasound-Assisted and Ultrasound-Guided Thoracentesis: An Educational Review

Safety and efficacy of tract embolization using gelatin sponge particles in reducing pneumothorax after CT-guided percutaneous lung biopsy in patients with emphysema

The safety and response of CT guided percutaneous cryoablation for lung nodules by 17-gauge needles

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