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Bending percutaneous drainage catheters to facilitate CT-guided insertion using curved trocar technique

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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Author information

Correspondence to Paul B. Shyn.

Ethics declarations

Funding

No funding was received for this study.

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

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.

Informed consent

Statement of informed consent was not applicable since the manuscript does not contain any patient data.

Additional information

This study was approved by the institutional review board.

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Supplementary material 1 (MOV 25028 kb)

Supplementary material 1 (MOV 25028 kb)

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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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Keywords

  • Catheter drainage
  • CT-guided
  • Trocar
  • Abdominal abscess
  • Pneumothorax