CT directed diagnostic and therapeutic pericardiocentesis: 8-year experience at a single institution

Abstract

Three hundred and nineteen pericardiocenteses using CT localization were attempted on 261 patients. One hundred and forty-two men were included and mean age was 61 years (range 6 months to 89 years). Mean volume aspirated was 418 cc (range 0-1,875 cc). The major complication rate was 0.3%; the minor complication rate was 6.9%. Technical success was achieved in 98.4% procedures. Emergent pericardiocentesis was performed on anticoagulated patients without significant bleeding. Seventy-nine percent of patients with echocardiographic evidence of tamponade had symptomatic improvement. Patients with marked shortness of breath without other evidence of tamponade benefited symptomatically in 78%. Pericardiocenteses with CT localization is relatively safe and many patients achieve symptomatic relief.

Imaging Findings in Cardiac Tamponade with Emphasis on CT

“…Klein et al (69) reviewed 319 CT-guided pericardiocentesis procedures and reported a technical success rate of 98.4%; symptomatic improvement was documented in 79% of patients with tamponade and in 78% of patients with marked shortness of breath without other evidence of tamponade.…”

Pericardicentesis and Contemporary Practice

“…In these situations, stereotactic devices or CT guided pericardiocentesis can be thought. In a study reported by Klein and his collagues major complication rate was 0.3% and minor complication rate was 6.9% and no death was observed (13).…”

Primary percutaneous balloon pericardiotomy for malignant pericardial effusion

“…Treatment, which is urgent in the presence of cardiac tamponade, is aimed primarily at removing the accumulated fluid. This may be done under echocardiographic, fluoroscopic, or computed tomographic guidance [8]. Drainage of such pericardial effusions may be achieved in a number of ways, although there is uncertainty as to which is the optimal approach.…”