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Binoy Kumar Choudhury
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P02 - Diagnostics and Interventional Pulmonology (ID 110)
- Event: WCLC 2020
- Type: Posters
- Track: Diagnostics and Interventional Pulmonology
- Presentations: 1
- Moderators:
- Coordinates: 1/28/2021, 00:00 - 00:00, ePoster Hall
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P02.15 - Intraparenchymal Blood Patch after CT Guided Biopsy of Lung and Mediastinal Lesions Reduces the Risk of Pneumothorax (ID 3252)
00:00 - 00:00 | Presenting Author(s): Binoy Kumar Choudhury
- Abstract
Introduction
Pneumothorax is the most common complication of CT-guided thoracic biopsy. A special technique may be used to minimize this complication. The purpose of this study was to determine whether this special technique using Intraparenchymal Blood Patch after CT guided biopsy of deep seated lung and mediastinal lesion can reduce and prevent the risk of pneumothrax.
Methods
We reviewed 31 CT guided lung and mediastinal biopsies performed between August 2018 to February 2020. Lung and mediastinal lesions having a biopsy path of at least 2 cm aerated lung were selected so that an effective blood patch seal might be applied. A standard biopsy protocol was used and any blebs,fissures and blood vessels in the biopsy pathway were avoided. Biopsy was performed with CT guidance using a coaxial system. A 19 gauge guiding needle was used, and a spring-loaded 20 gauge semiautomatic biopsy gun was used to obtain core tissue sample. 3 ml to 8 ml of patient’s blood ( nonclotted or partially clotted ) was injected into the needle track while the guiding needle was withdrawn, filling the entire needle track from the biopsy site to the visceral pleura. Immediately after withdrawing the needle, puncture site of the patient was put on dependant position. CT Scan was performed in that position to see any evidence of pneumothorax. The patients were kept in that position for 1-2 hours. Chest skiagram was performed two hours after the procedure to see any pneumothorax.
Results
Intraparenchymal Blood Patch Technique after biopsy was performed in 31 deep seated and risky lung and mediastinal masses ranging from 10 mm to 26 mm sizes in the age group of 33 to 69 years. 25.8% of lesions were mediastinal and rest 74.2% were lung lesions. Distance of aerated lung traversed by the biopsy needle ranged from 2 cm to 5 cm. Only one patient developed a very small pneumothorax. Post procedure CT scan revealed this very small pneumothorax and it was not seen in chest skiagram taken two hours after the procedure.
Conclusion
The use of intraparenchymal blood patch technique after biopsy of deep seated lung and mediastinal lesions significantly reduces and prevents the risk of pnemothorax. This technique appears to be more beneficial when 20 gauge biopsy needle and immediate dependant positioning of puncture site is used.
