Risk factors for air embolism following computed tomography-guided percutaneous transthoracic needle biopsy: a systematic review and meta-analysis

Zhang, Hanfei; Wang, Shan; Zhong, Feiyang; Liao, Meiyan

doi:10.4274/dir.2022.221187

Cited by 9 publications

(8 citation statements)

References 102 publications

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“…Air embolism may result from the formation of a bronchovascular fistula, emphasizing the importance of precise needle puncture 38 . Coughing, a common occurrence during procedures, poses a risk of pneumothorax or air embolism if the needle's tip is exposed in a vein 55 . Factors associated with cough during the procedure include more frequent and deeper ablations, which induced more inflammation close to the bronchus.…”

Section: Discussionmentioning

confidence: 99%

Enhancing precision in lung tumor ablation through innovations in CT‐guided technique and angle control

Hung,

Tsai,

et al. 2024

Thoracic Cancer

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BackgroundThis retrospective study aimed to evaluate the precision and safety outcomes of image‐guided lung percutaneous thermal ablation (LPTA) methods, focusing on radiofrequency ablation (RFA) and microwave ablation (MWA). The study utilized an innovative angle reference guide to facilitate these techniques in the treatment of lung tumors.MethodsThis study included individuals undergoing LPTA with the assistance of laser angle guide assembly (LAGA) at our hospital between April 2011 and March 2021. We analyzed patient demographics, tumor characteristics, procedure details, and complications. Logistic regressions were employed to assess risk factors associated with complications.ResultsA total of 202 patients underwent ablation for 375 lung tumors across 275 sessions involving 495 ablations. Most procedures used RFA, especially in the right upper lobe, and the majority of ablations were performed in the prone position (49.7%). Target lesions were at a median depth of 39.3 mm from the pleura surface, and remarkably, 91.9% required only a single puncture. Complications occurred in 31.0% of ablations, with pneumothorax being the most prevalent (18.3%), followed by pain (12.5%), sweating (6.5%), fever (5.0%), cough (4.8%), hemothorax (1.6%), hemoptysis (1.2%), pleural effusion (2.0%), skin burn (0.6%), and air emboli (0.2%). The median procedure time was 21 min. Notably, smoking/chronic obstructive pulmonary disease emerged as a significant risk factor for complications.ConclusionThe LAGA‐assisted LPTA enhanced safety by improving accuracy and reducing risks. Overall, this investigation contributes to the ongoing efforts to refine and improve the clinical application of these thermal ablation techniques in the treatment of lung tumors.

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Section: Discussionmentioning

confidence: 99%

Enhancing precision in lung tumor ablation through innovations in CT‐guided technique and angle control

Hung,

Tsai,

et al. 2024

Thoracic Cancer

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“…Systemic air embolism, although rare, represents a potentially catastrophic complication of CTTCB, with an estimated incidence of approximately 0.03-0.07% based on extensive case series [9,37]. The immediate detection of air emboli on CT scans is crucial in such cases.…”

Section: Discussionmentioning

confidence: 99%

“…Notably, our study with CTTCB-LAGA did not observe any instances of air embolism. The proposed risk factors for systemic air embolism include needle entry into pulmonary venous structures, biopsy of consolidative lung lesions, and the repetition of puncturing and repositioning the needle [37,38]. Patient coughing or gasping during the procedure may also contribute to increasing intra-thoracic pressure.…”

Section: Discussionmentioning

confidence: 99%

Optimizing Precision: A Trajectory Tract Reference Approach to Minimize Complications in CT-Guided Transthoracic Core Biopsy

Tsai,

Wu,

Lin

2024

Diagnostics

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The advent of computed tomography (CT)-guided transthoracic needle biopsy has significantly advanced the diagnosis of lung lesions, offering a minimally invasive approach to obtaining tissue samples. However, the technique is not without risks, including pneumothorax and hemorrhage, and it demands high precision to ensure diagnostic accuracy while minimizing complications. This study introduces the Laser Angle Guide Assembly (LAGA), a novel device designed to enhance the accuracy and safety of CT-guided lung biopsies. We retrospectively analyzed 322 CT-guided lung biopsy cases performed with LAGA at a single center over seven years, aiming to evaluate its effectiveness in improving diagnostic yield and reducing procedural risks. The study achieved a diagnostic success rate of 94.3%, with a significant reduction in the need for multiple needle passes, demonstrating a majority of biopsies successfully completed with a single pass. The incidence of pneumothorax stood at 11.1%, which is markedly lower than the reported averages, and only 0.3% of cases necessitated chest tube placement, underscoring the safety benefits of the LAGA system. These findings underscore the potential of LAGA to revolutionize CT-guided lung biopsies by enhancing procedural precision and safety, making it a valuable addition to the diagnostic arsenal against pulmonary lesions.

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“… 32 To diagnose lung cancer, percutaneous transthoracic needle aspiration biopsy can also induce complications including pneumothorax and air embolism. 33 34 In this study, we used simple bronchial washing fluid. It is less invasive than other procedures with complications.…”

Section: Discussionmentioning

confidence: 99%

Combination Analysis of PCDHGA12 and CDO1 DNA Methylation in Bronchial Washing Fluid for Lung Cancer Diagnosis

Park,

Kang,

Lee

et al. 2024

J Korean Med Sci

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Background When suspicious lesions are observed on computer-tomography (CT), invasive tests are needed to confirm lung cancer. Compared with other procedures, bronchoscopy has fewer complications. However, the sensitivity of peripheral lesion through bronchoscopy including washing cytology is low. A new test with higher sensitivity through bronchoscopy is needed. In our previous study, DNA methylation of PCDHGA12 in bronchial washing cytology has a diagnostic value for lung cancer. In this study, combination of PCDHGA12 and CDO1 methylation obtained through bronchial washing cytology was evaluated as a diagnostic tool for lung cancer. Methods A total of 187 patients who had suspicious lesions in CT were enrolled. PCDHGA12 methylation test, CDO1 methylation test, and cytological examination were performed using 3-plex LTE-qMSP test. Results Sixty-two patients were diagnosed with benign diseases and 125 patients were diagnosed with lung cancer. The sensitivity of PCDHGA12 was 74.4% and the specificity of PCDHGA12 was 91.9% respectively. CDO1 methylation test had a sensitivity of 57.6% and a specificity of 96.8%. The combination of both PCDHGA12 methylation test and CDO1 methylation test showed a sensitivity of 77.6% and a specificity of 90.3%. The sensitivity of lung cancer diagnosis was increased by combining both PCDHGA12 and CDO1 methylation tests. Conclusion Checking DNA methylation of both PCDHGA12 and CDO1 genes using bronchial washing fluid can reduce the invasive procedure to diagnose lung cancer.

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Risk factors for air embolism following computed tomography-guided percutaneous transthoracic needle biopsy: a systematic review and meta-analysis

Abstract: Risk factors of air embolism following computed tomography-guided percutaneous transthoracic needle biopsy -a systematic review and meta-analysis. Diagn Interv Radiol.

Cited by 9 publications

References 102 publications

Enhancing precision in lung tumor ablation through innovations in CT‐guided technique and angle control

Enhancing precision in lung tumor ablation through innovations in CT‐guided technique and angle control

Optimizing Precision: A Trajectory Tract Reference Approach to Minimize Complications in CT-Guided Transthoracic Core Biopsy

Combination Analysis of PCDHGA12 and CDO1 DNA Methylation in Bronchial Washing Fluid for Lung Cancer Diagnosis

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