Clinical outcomes of image‐guided percutaneous drainage of pericardial effusion in cancer patients: A single‐center retrospective analysis

Abstract

Aim Catheter removal, survival, and recurrence rates after percutaneous pericardial effusion drainage in cancer patients are not fully understood. We evaluated the clinical outcomes of image‐guided percutaneous pericardial effusion drainage in cancer patients. Methods From January 2014 to September 2017, 113 percutaneous drainages for symptomatic pericardial effusion were performed in 100 cancer patients (median 60 years; range, 7–84 years) using ultrasound or angio‐computed tomography. An 8‐Fr drainage catheter was placed using the Seldinger technique via the subxiphoid (n = 73), apical (n = 23), or left parasternal (n = 17) routes. Success rates, complications, and postprocedural clinical outcomes of drainages were retrospectively assessed. Results The technical and clinical success rates were 100% and 99%, respectively, without major complications. The median duration of catheterization and evacuated pericardial effusion volume were 6 days (range, 1–72 days) and 970 ml (range, 140–7635 ml), respectively. Catheters were removed after the first drainage in 86 cases (86%). Symptomatic pericardial effusion recurred in nine patients after catheter removal, in whom redrainages were performed 13 times with a median duration to redrainage time of 48 days (range, 13–529 days). During the follow‐up period (median 106 days [range, 1–1396 days]), 61 patients died. The median survival was 140 days (95% confidence interval [CI], 95–276 days), and the median catheter‐free survival was 111 days (95% CI, 60–152 days). Conclusions Image‐guided percutaneous pericardial effusion drainage for cancer patients is safe and helps alleviate symptoms. Additionally, catheter removal is possible in most patients, allowing a catheter‐free period for patients.

The BALTO Registry: Long‐term results of percutaneous BALloon pericardioTomy in oncological patients

“…Compared to surgical approach, PC is a less aggressive technique but is associated with a high recurrence rate (38%) when performed as an isolated procedure 10 . The use of an indwelling pericardial catheter after PC for extended drainage of a pericardial effusion significantly reduces the recurrence rate of MPE (12%–14%) and is a relatively safe procedure 17–19 . For this reason, PC in combination with an extended catheter drainage is the technique of choice in many centers.…”

“…10 The use of an indwelling pericardial catheter after PC for extended drainage of a pericardial effusion significantly reduces the recurrence rate of MPE (12%-14%) and is a relatively safe procedure. [17][18][19] For this reason, PC in combination with an extended catheter drainage is the technique of choice in many centers. However, maintenance of pericardial drainage can prolong hospital stay, cause chest pain due to pericardial inflammation from the indwelling catheter and, although relatively rare, predispose patients to catheter-related infections.…”