Usefulness of normal saline for sealing the needle track after CT-guided lung biopsy

Li, Y.; Du, Yuchen; Luo, Tianyou; Yang, Hua-Yuan; Yu, Jin; Xu, Xiaoxue; Zheng, Hou-Jun; Li, B.

doi:10.1016/j.crad.2015.06.081

Cited by 41 publications

(43 citation statements)

References 22 publications

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“…These reductions are similar to that seen in evaluations of other sealants including gel foam, 9,10 fibrin glue, 13 biopsy plugs, 14,15 and normal saline. 11,12 The benefits of the nonclotted blood patch procedure (as opposed to the more common clotted blood patch) are multiple. First, it requires less time to implement, given no delay is needed for blood clotting.…”

Section: Discussionmentioning

confidence: 99%

Nonclotted Blood Patch Technique Reduces Pneumothorax and Chest Tube Placement Rates After Percutaneous Lung Biopsies

Clayton

Elicker

Ordovás

et al. 2016

Journal of Thoracic Imaging

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Purpose: The aim of this study was to determine whether autologous nonclotted blood patch decreases pneumothorax and chest tube placement rates in computed tomography–guided biopsies of the lung. Materials and Methods: Percutaneous computed tomography–guided lung biopsies performed over a period of 6 years were retrospectively reviewed to determine the overall rates of pneumothorax and chest tube placement and rates before and after the autologous nonclotted blood patch procedure was instituted as a departmental policy. The effect of the intervention was only assessed in patients in whom a blood patch could be applied, therefore only when the needle traversed an aerated lung and only when the needle remained in the lung at the end of the study. Results: There was a statistically significant decrease in both the rate of pneumothorax [28% (69/245) vs. 42% (80/189); P=0.002] and chest tube placement [4% (10/245) vs. 16% (30/189); P<0.001] in patients who received nonclotted blood patch versus those who did not. Blood patch was performed in 222/312 (71%) eligible patients after the introduction of the blood patch policy. After policy introduction, there was a decreased rate of pneumothorax, with a rate of 32% (101/312) versus 40% (49/122) (P=0.12) and a statistically significant decrease in departmental chest tube placement rates of 6% (20/312) versus 16% (20/122) (P=0.001). Conclusions: Nonclotted autologous blood patch for percutaneous lung biopsy resulted in significantly decreased pneumothorax and chest tube placement rates in our patient population.

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Section: Discussionmentioning

confidence: 99%

Nonclotted Blood Patch Technique Reduces Pneumothorax and Chest Tube Placement Rates After Percutaneous Lung Biopsies

Clayton

Elicker

Ordovás

et al. 2016

Journal of Thoracic Imaging

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“…The use of saline reduced the incidence of pneumothorax to 6.2% compared with 26.1% in the control group (p<0.001) [36], whilst the "rapid roll-over" method reduced the incidence of pneumothoraces requiring drains, but not the overall incidence of pneumothorax [37]. More trials are necessary before these techniques become common practice.…”

Section: Complications From Image-guided Biopsiesmentioning

confidence: 99%

“…Pneumothorax risk may be reduced by injecting saline as the biopsy needle is withdrawn, or by rapidly turning the patient onto the side of the biopsy once the procedure is complete [36,37].…”

Section: Complications From Image-guided Biopsiesmentioning

confidence: 99%

Pleural biopsies in undiagnosed pleural effusions; Abrams vs image-guided vs thoracoscopic biopsies

Bibby

Maskell

2016

Current Opinion in Pulmonary Medicine

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General rightsThis document is made available in accordance with publisher policies. Please cite only the published version using the reference above. Full terms of use are available: http://www.bristol.ac.uk/pure/about/ebr-terms However this service is not universally available and may be unsuitable for some patients.Image-guided cutting-needle biopsies under computed tomography or ultrasound guidance have high diagnostic rates and are useful in a wide patient population. The main role of Abrams biopsies is in the diagnosis of tuberculous pleuritis in resource-poor settings.

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“…A variety of approaches to the technique have been evaluated in an attempt to reduce the rate of TTNBs-related pneumothorax (4,5). Simple aspiration and tube thoracostomy were recommended to deal with the pneumothorax.…”

Section: Original Articlementioning

confidence: 99%

“…Thus reduce the rate of pneumothorax requiring drainage catheter placement. (4,5). Simple aspiration and tube thoracostomy were recommended to deal with the pneumothorax.…”

mentioning

confidence: 99%

Manual aspiration in the biopsy-side down position to deal with delayed pneumothorax after lung biopsy

Zeng

Yang

et al. 2018

J. Thorac. Dis.

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Background:To assess the effect of aspiration in the biopsy-side down position to deal with delayed pneumothorax after computed tomography (CT)-guided lung biopsy.Methods: A retrospective review was performed of the 236 delayed pneumothorax patients who underwent CT-guided transthoracic needle biopsies (TTNBs). Asymptomatic minimal pneumothorax patients were managed conservatively. Manual aspirations were applied for symptomatic cases with minimal pneumothorax and all cases with moderate to large pneumothorax. Patients were included into two groups: in group A (35 patients), aspiration was performed in the same position as the biopsy, while in group B (54 patients), patients were turned to the biopsy-side down position (from supine to prone or vice versa), and aspiration was conducted. The efficacy of two approaches was evaluated.Results: One hundred forty-seven (62.3%) asymptomatic cases resolved without treatment. Distance between parietal and visceral pleura before and after aspiration were 4.24±1.87 and 1.93±2.33 cm for group A, 3.92±1.31 and 0.98±1.50 cm for group B, respectively. Volume of aspirated air in group A and group B were 735.4±231.8 and 434.8±320.3 mL, respectively. Complete lung expansion was detected in 28.6% (10/35) and 38.9% (21/54) for group A and group B, respectively. The overall effective rate and failure rate were 74.3% (26/35) and 25.7%(9/35) for group A, 92.6% (50/54) and 7.4%((4/54)(for group B, respectively, which have significant statistic difference (P<0.05).Conclusions: Manual aspiration in biopsy-side down position demonstrates the safety and efficacy in treating delayed pneumothorax after CT-guided TTNBs. Thus reduce the rate of pneumothorax requiring drainage catheter placement. (4,5). Simple aspiration and tube thoracostomy were recommended to deal with the pneumothorax. As reported, tube thoracostomy is associated with more complications and resulted in a longer stay in hospital than simple aspiration (6). Many previous reports have shown that increasing delayed pneumothoraces often need chest tube placement. Patient positioning after biopsy has been studied but remains controversial, some study found that placing the patients biopsy-side down (from prone to supine or vice versa) after biopsy substantially reduced the rate of pneumothorax (5,7), while some other articles found no effect (8,9). Anecdotally, we noted in practice some satisfactory results were achieved by using aspiration in biopsy-side down position. We reported our preliminary experience using a modified manual aspiration in the biopsy-side down position in an attempt to deal with delayed pneumothorax caused by biopsy, thus reduce the application of tube thoracostomy significantly. MethodsThis retrospective study was approved by the Ethical Committee and Institutional Review Board of Affiliated Hospital of North Sichuan Medical College (No. NSMC1601-018). A retrospective review was performed of the clinical records and radiological findings of 1750 consecutive patients who underwent CT-guided TTNB for lung le...

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Usefulness of normal saline for sealing the needle track after CT-guided lung biopsy

Cited by 41 publications

References 22 publications

Nonclotted Blood Patch Technique Reduces Pneumothorax and Chest Tube Placement Rates After Percutaneous Lung Biopsies

Nonclotted Blood Patch Technique Reduces Pneumothorax and Chest Tube Placement Rates After Percutaneous Lung Biopsies

Pleural biopsies in undiagnosed pleural effusions; Abrams vs image-guided vs thoracoscopic biopsies

Manual aspiration in the biopsy-side down position to deal with delayed pneumothorax after lung biopsy

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