REGULAR CONTENT
Final ID
472
Type
Original Scientific Research-Oral or Pos
Authors
C Hua1, A Patel1, L Perez1, C Wada1, R Dreifuss1, A Friedman1
Institutions
1Mount Sinai St. Luke's-West Hospitals, New York, NY
Purpose
Pneumothorax is the most common complication of CT guided lung biopsies with clinically significant pneumothoraces requiring tube thoracostomy and hospitalization at the hospital's expense. This study aims to assess the effectiveness of a biopsy tract plug on reducing biopsy related pneumothorax and tube thoracostomy.
Materials & Methods
A retrospective review of 298 CT guided lung biopsies utilizing a 19/20 gauge coaxial system between January 2013 and August 2016 were evaluated. Chi square analysis was performed on 149 patients following the use of a self expanding hydrogel biopsy tract plug device and on 149 patients without the biopsy plug device. Pneumothorax and the need for chest tube were evaluated with CT immediately postprocedure, with follow up chest x-rays at 1 and 4 hours postprocedure, and additional x-rays as clinically warranted.
Results
Pneumothoraces were observed in 75/149 (50%) patients without the biopsy plug and 53/149 (36%) patients with the biopsy plug (p = 0.01). Of the 75 patients who developed a pneumothorax without the biopsy plug, 5 were observed intraprocedurally, 48 immediately postprocedure, 7 on the first radiograph, 14 on the second radiograph, and 1 at 7 hours postprocedure. In the 53 patients who developed a pneumothorax with the use of a biopsy plug, 8 were observed intraprocedurally, 29 immediately postprocedure, 11 on the first radiograph, 4 on the second radiograph, and 1 at 7 hours postprocedure.Chest tubes were placed in 24/149 (16%) patients without the biopsy plug and in 5/149 (3%) patients treated with the biopsy plug (p = 0.0002). Of the 24 patients needing a chest tube without the biopsy plug, 6 were placed after the first radiograph, 11 after the second radiograph, 1 at 5 hours postprocedure, 5 at 24 hours postprocedure, and 1 at 7 days postprocedure. In the 5 patients needing chest tube after being treated with the biopsy plug, 4 were placed immediately postprocedure and 1 was placed after the second radiograph.
Conclusions
The biopsy plug significantly reduced the rate of pneumothorax from CT-guided lung biopsy. More importantly, there was a greater effect on reducing the incidence of biopsy related thoracostomy tube placement and hospital admissions.
Final ID
472
Type
Original Scientific Research-Oral or Pos
Authors
C Hua1, A Patel1, L Perez1, C Wada1, R Dreifuss1, A Friedman1
Institutions
1Mount Sinai St. Luke's-West Hospitals, New York, NY
Purpose
Pneumothorax is the most common complication of CT guided lung biopsies with clinically significant pneumothoraces requiring tube thoracostomy and hospitalization at the hospital's expense. This study aims to assess the effectiveness of a biopsy tract plug on reducing biopsy related pneumothorax and tube thoracostomy.
Materials & Methods
A retrospective review of 298 CT guided lung biopsies utilizing a 19/20 gauge coaxial system between January 2013 and August 2016 were evaluated. Chi square analysis was performed on 149 patients following the use of a self expanding hydrogel biopsy tract plug device and on 149 patients without the biopsy plug device. Pneumothorax and the need for chest tube were evaluated with CT immediately postprocedure, with follow up chest x-rays at 1 and 4 hours postprocedure, and additional x-rays as clinically warranted.
Results
Pneumothoraces were observed in 75/149 (50%) patients without the biopsy plug and 53/149 (36%) patients with the biopsy plug (p = 0.01). Of the 75 patients who developed a pneumothorax without the biopsy plug, 5 were observed intraprocedurally, 48 immediately postprocedure, 7 on the first radiograph, 14 on the second radiograph, and 1 at 7 hours postprocedure. In the 53 patients who developed a pneumothorax with the use of a biopsy plug, 8 were observed intraprocedurally, 29 immediately postprocedure, 11 on the first radiograph, 4 on the second radiograph, and 1 at 7 hours postprocedure.Chest tubes were placed in 24/149 (16%) patients without the biopsy plug and in 5/149 (3%) patients treated with the biopsy plug (p = 0.0002). Of the 24 patients needing a chest tube without the biopsy plug, 6 were placed after the first radiograph, 11 after the second radiograph, 1 at 5 hours postprocedure, 5 at 24 hours postprocedure, and 1 at 7 days postprocedure. In the 5 patients needing chest tube after being treated with the biopsy plug, 4 were placed immediately postprocedure and 1 was placed after the second radiograph.
Conclusions
The biopsy plug significantly reduced the rate of pneumothorax from CT-guided lung biopsy. More importantly, there was a greater effect on reducing the incidence of biopsy related thoracostomy tube placement and hospital admissions.