Abstract
Purpose
To assess the safety and efficacy of placing thoraco-abdominal drainage catheters under CT-guidance using a curved trocar technique.
Methods
A retrospective study of 182 CT/CT-fluoroscopy-guided thoraco-abdominal catheter drainages was conducted; half were performed by residents or fellows under the supervision of one radiologist (Group 1) and the other half under the supervision of 10 other radiologists (Group 2). Group 1 procedures employed a curved catheter assembly placed using trocar technique (n = 44) or straight catheters placed with Seldinger technique (n = 47). Group 2 procedures employed a straight catheter placed using trocar technique (n = 16) or straight catheters placed with Seldinger technique (n = 75). Technical success, procedure time, radiation dose (CT Dose Index CTDIvol), and adverse events (Common Terminology Criteria for Adverse Events, 4.0) were compared between techniques and groups using Student’s t test, Fisher’s exact test or Chi-square analysis.
Results
All procedures in groups 1 and 2 were technically successful. Mean procedure time for Group 1 curved trocar technique (28 ± 8 min) was shorter than groups 1 and 2 Seldinger technique (37 ± 11 min, p = .00002). Mean CTDIvol for Group 1 curved trocar technique (107.8 ± 54.2 mGy) was lower than groups 1 and 2 Seldinger technique (136.1 ± 99.7 mGy, p = 0.032). Adverse event rates for curved trocar, straight trocar, and Seldinger techniques were 2.3% (1/44), 0% (0/16), and 3.3% (4/122), respectively (p = 1); all were grade 1 or 2, and no catheter malfunctions occurred.
Conclusions
The curved catheter trocar technique is a safe and effective modification of the standard trocar technique that may facilitate CT-guided procedures impeded by CT gantry size limitations.
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No funding was received for this study.
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The authors declare that they have no conflict of interest.
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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. For this type of study, formal consent is not required.
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Statement of informed consent was not applicable since the manuscript does not contain any patient data.
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This study was approved by the institutional review board.
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Young, A.S., Shyn, P.B., Johnson, O.W. et al. Bending percutaneous drainage catheters to facilitate CT-guided insertion using curved trocar technique. Abdom Radiol 42, 2160–2167 (2017). https://doi.org/10.1007/s00261-017-1108-5
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DOI: https://doi.org/10.1007/s00261-017-1108-5