Computed Tomography-Fluoroscopy Guided Drainage of Pericardial Effusions

Abstract

Visual surveillance by CT-fluoroscopy is a feasible method in the drainage of pericardial effusions even in cases not accessible by ultrasound.

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

“…In this study patients presented with a PE (assessed by echocardiography) which was considered not drainable by ultrasound guidance. 10 It should be acknowledged, however, that different definitions (namely technical versus clinical) were used in different studies. For example, in the study by Klein and colleagues, technical success was reported in 98.4% of cases.…”

“…2,7,8 Given these possible shortcomings in terms of image acquisition as well as the necessity for a precise needle orientation (especially in nontypical approaches), computed tomography (CT)-guided pericardiocentesis has gained interest. 6,9,10 This technique, some of the first descriptions of which concerning PE diagnosis and possible pericardiocentesis guidance were made over 30 years ago, 11,12 has been thoroughly detailed elsewhere. 6,7,13 It potentially allows overcoming many of the hindrances concerning echocardiography, and can also be relevant for the exclusion of other thoracic pathologies.…”

Computed tomography-guided drainage of pericardial effusion

“…Computed tomography-guided drainage of pericardial effusions was successfully performed in 96% of our cases (n=28), and CT-guided drainage has been proven to be reliable even when pigtail catheters are used for diagnostic purposes. Furthermore, Bruning et al [11] described the use of CT-fluoroscopy and pericardial drainage. These catheters are rigid and breakable; therefore, we preferred using the nephrostomy catheter since it is soft and unbreakable.…”

Successful Computed Tomography-guided Pericardiocentesis after Performing a Failed Conventional Transthoracic Echocardiography-guided Approach: A Case Report

“…CT-guided pericardiocentesis is a safe and effective treatment option for patients with PE. Neves et al reported that CT-guided pericardiocentesis was successful in 94% of patients, and that unsuccessful cases had localized or organized PE, which was shown to be unsuitable for percutaneous drainage 4,8 . Furthermore, Bruning et al reported that CT-guided pericardiocentesis was successfully performed in 10 of 11 cases, including eight patients where TTE guidance was determined to be inappropriate 3 .…”

“…Conventional echocardiography-guided pericardiocentesis is contraindicated in patients due to the absence of an optimal acoustic window, which is typically associated with chronic obstructive pulmonary disease, obesity, or post-thoracic surgery. One potential reason for the lack of guidance concerning CT-guided pericardiocentesis is that evidence supporting the competitive advantage of CT guidance over transthoracic echocardiography (TTE) is still lacking [3][4][5] . Thus, the optimal application of CT guidance for pericardiocentesis is unclear.…”