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Efficacy of the tract embolization technique with gelatin sponge slurry to reduce pneumothorax and chest tube placement after percutaneous CT-guided lung biopsy

  • Hadrien Renier
  • Laurent Gérard
  • Pierre Lamborelle
  • François CousinEmail author
Clinical Investigation Non-Vascular Interventions
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Part of the following topical collections:
  1. Non-Vascular Interventions

Abstract

Purpose

To assess the efficacy of the tract embolization technique using gelatin sponge slurry after CT-guided lung biopsy to reduce pneumothorax and chest tube placement rates.

Materials and Methods

We retrospectively compared 231 CT-guided lung biopsies performed with the tract embolization technique using gelatin sponge slurry (treated group) with 213 biopsies performed without embolization (control group). All procedures were performed at our institution between January 2014 and September 2018 by one of three experienced interventional radiologists using a 19-gauge coaxial needle. Multivariate analysis was performed between groups for risk factors for pneumothorax and chest tube placement, including patient demographics and lesion characteristics.

Results

When comparing the two groups, there was no significant difference concerning age, gender, emphysema, lesion size, lesion location, lesion morphology, needle tract depth and biopsy-side down patient positioning. Compared to the control group, patients with gelatin sponge slurry tract embolization had statistically lower rates of pneumothorax (10% vs. 25.8%; p < 0.0001) and chest tube placement (3.5% vs. 12.2%; p = 0.0005). Using multiple logistic regression analysis, the only variable that had an influence on the pneumothorax rate was the group (OR 0.32, 95% CI 0.18–0.56, p < 0.0001), and the variables that had an influence on the chest tube insertion rates were the group (OR 0.21, 95% CI 0.08–0.51, p = 0.0006) and presence of emphysema (OR 3.50, 95% CI 1.53–8.03, p = 0.0031).

Conclusions

Tract embolization technique using gelatin sponge slurry after percutaneous CT-guided lung biopsy significantly reduces pneumothorax and chest tube placement rates.

Level of Evidence

Level 3a.

Keywords

Lung Biopsy Pneumothorax Chest tube Gelfoam 

Abbreviations

GSS

Gelatin sponge slurry

SD

Standard deviation

OR

Odds ratio

CI

Confidence interval

Notes

Funding

This study was not supported by any funding.

Compliance with Ethical Standards

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.

Informed Consent

This study has obtained IRB approval from the Comité d’éthique Hospitalo-Facultaire Universitaire de Liège, and the need for informed consent was waived.

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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature and the Cardiovascular and Interventional Radiological Society of Europe (CIRSE) 2019

Authors and Affiliations

  1. 1.Department of ImagingCentre Hospitalier Universitaire de LiègeLiègeBelgium
  2. 2.Department of Nuclear Medicine and Cancer ImagingCentre Hospitalier Universitaire de LiègeLiègeBelgium

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