Technical aspects of needle aspiration lung biopsy: a personal perspective.

Moore, Elizabeth Hernández

doi:10.1148/radiology.208.2.9680552

Cited by 135 publications

(86 citation statements)

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“…2,7 This discrepancy can be attributed to multiple variables in each individual study including: patient characteristics, that is, presence of emphysema and size and location of the lesions, lesion inclusion criteria, and the method of diagnosing pneumothorax, be it CT and CXR or CXR alone, among multiple other factors. [1][2][3][4][5][6][7][8] A blood patch rate of 71% during the postpolicy period was less than our expected rate of 80%. Insufficient information was available in the records to indicate why the blood patch technique was not used in all patients.…”

Section: Discussioncontrasting

confidence: 66%

“…Various interventions have been considered to reduce the risk for pneumothorax including avoiding or reducing the number of passes through the pleura, avoidance of areas of emphysema, varying needle size, depth and angle of trajectory, and postprocedural patient positioning (patient supine, puncture side down, etc.). [1][2][3][4][5][6][7][8] Sealant techniques have been an area of debate since their initial description. Many sealant materials have been studied, with autologous clotted blood being the most commonly described agent.…”

Section: Methodsmentioning

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: Discussioncontrasting

confidence: 66%

Section: Methodsmentioning

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 needle path can be demonstrated on only the axial imaging plane during needle insertion and patient's cooperation with breath holding is critical to the success and safety of the procedure [19]. Furthermore, the operators must handle the needle manually or with the aid of a needle holder device within the limited CT gantry, resulting in considerable radiation exposure to the operator's hand and unavoidable discomfort during the performance of the procedure [20].…”

Section: Discussionmentioning

confidence: 99%

Initial experience of percutaneous transthoracic needle biopsy of lung nodules using C-arm cone-beam CT systems

et al. 2010

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“…[8][9][10][11] CT has extended the use of FNA because it is more accurate for localization and needle puncture but, above all, because of its ability to permit investigation of lesions < 1 cm. [12][13][14] Thus, the diagnosis of malignant disease by FNA can be made at an early stage.…”

Section: Discussionmentioning

confidence: 99%