fibrin glue for sealing the needle track in fine-needle percutaneous lung biopsy using a coaxial system: Part II?clinical study

Petsas, Theodore; Siamblis, Dimitris; Giannakenas, Costas; Tepetes, Kostas; Dougenis, D.; Spiropoulos, Kostas; Fezoulidis, I.; Dimopoulos, Ioannis

doi:10.1007/bf00338305

Cited by 49 publications

(29 citation statements)

References 15 publications

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“…Malone et al, 19 in a larger prospective trial including 242 patients, reached statistical significance in chest tube reduction and noted a nonstatistically significant decrease in the pneumothorax rate. 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.…”

Section: Discussionsupporting

confidence: 80%

“…Sealant techniques were first described in 1974 by McCartney and colleagues utilizing both autologous clotted blood and gel foam. 9,10 Since then a variety of other materials have been used including sterile saline, 11,12 fibrin glue, 13 and specially formulated biopsy plugs. 14,15 The most commonly studied agent has been autologous clotted blood, often called a "blood patch."…”

Section: Discussionmentioning

confidence: 99%

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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: Discussionsupporting

confidence: 80%

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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show abstract

“…In 1995, Petsas, et al (12) introduced fibrin glue as an agent to seal the track in fine-needle percutaneous lung biopsy. The severity of pneumothorax decreased in patients with percutaneous lung biopsy.…”

Section: Discussionmentioning

confidence: 99%

A novel CT-guided technique using medical adhesive for localization of small pulmonary ground-glass nodules and mixed ground-glass nodules (≤20 mm) before video-assisted thoracoscopic surgery

Guo

et al. 2018

Diagn Interv Radiol

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“…A multitude of sealing techniques with blood clot [9][10][11][12], liquid blood [13], collagen [14], fibrin [15], and isobutyl-2-cyanoacrylate [16] have been used with varying success. Using these methods, a reduction in the pneumothorax rate of up to .8% has been reported.…”

Section: Introductionmentioning

confidence: 99%

CT-guided lung biopsy: incidence of pneumothorax after instillation of NaCl into the biopsy track

et al. 2008

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This study was conducted to evaluate whether instillation of NaCl 0.9% solution into the biopsy track reduces the incidence of pneumothoraces after CT-guided lung biopsy. A total of 140 consecutive patients with pulmonary lesions were included in this prospective study. All patients were alternatingly assigned to one of two groups: group A in whom the puncture access was sealed by instillation of NaCl 0.9% solution during extraction of the guide needle (n = 70) or group B for whom no sealing was performed (n = 70). CT-guided biopsy was performed with a 18-G coaxial system. Localization of lesion (pleural, peripheral, central), lesion size, needle-pleural angle, rate of pneumothorax and alveolar hemorrhage were evaluated. In group A, the incidence of pneumothorax was lower compared to group B (8%, 6/70 patients vs. 34%, 24/70 patients; P < 0.001). All pneumothoraces occurred directly post punctionem after extraction of the guide needle. One patient in group A and eight patients in group B developed large pneumothoraces requiring chest tube placement (P = 0.01). The frequency of pneumothorax was independent of other variables. After CT-guided biopsy, instillation of NaCl 0.9% solution into the puncture access during extraction of the needle significantly reduces the incidence of pneumothorax.

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fibrin glue for sealing the needle track in fine-needle percutaneous lung biopsy using a coaxial system: Part II?clinical study

Abstract: Our results indicate that fibrin glue is a safe sealing material for lung PLB and serves to decrease the incidence and, in particular, the severity of pneumothorax, especially in high-risk patients.

Cited by 49 publications

References 15 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

A novel CT-guided technique using medical adhesive for localization of small pulmonary ground-glass nodules and mixed ground-glass nodules (≤20 mm) before video-assisted thoracoscopic surgery

CT-guided lung biopsy: incidence of pneumothorax after instillation of NaCl into the biopsy track

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