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Image-Guided Drainage of Pericardial Effusions in Oncology Patients

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Abstract

The purpose of this study was to report our clinical experience with image-guided drainage of pericardial effusions in oncology patients. IRB approval was obtained for this retrospective, HIPAA-compliant study. From November 2002 to January 2008, 40 patients underwent 43 image-guided drainages of pericardial effusions. The medical records were reviewed to analyze the technical aspects of the procedures, complications, and clinical outcomes. Thirty-three pericardial drains were placed and 10 pericardiocenteses were performed. The technical success rate was 100%. Thirty-three procedures were performed under computed tomographic (CT) guidance, five under ultrasound (US) guidance, and five using both CT and US guidance. There were no technical, procedure-related complications. Delayed postprocedure complications and arrhythmias occurred in 11 cases, for an overall complication rate of 25.6%. All complications occurred in patients who had undergone drain placement. Nine patients developed new or worsening arrhythmias and six of these patients required transfer to a higher level of care or the initiation of pharmacological management. In 58.6% of drain placements, including 4 of 11 patients who developed complications, the catheter could have been removed earlier. The median overall survival was 6.47 months (95% CI: 2.37, 12.7). In conclusion, image-guided pericardial drain placement is safe and feasible. Due to the frequency of delayed postprocedure arrhythmias, follow-up monitoring in a telemetry unit is recommended. Prompt catheter removal after drainage may reduce the incidence of delayed post-catheter-insertion arrhythmias.

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Authors and Affiliations

  1. Department of Diagnostic Radiology, Interventional Radiology Section, Unit 325, The University of Texas M.D. Anderson Cancer Center, 1515 Holcombe Boulevard, Houston, TX, 77030, USA

    Alda Tam, Holly Snyder, Sanjay Gupta & Michael J. Wallace

  2. Department of Biostatistics and Applied Mathematics, The University of Texas M.D. Anderson Cancer Center, Houston, TX, 77030, USA

    Joe E. Ensor

  3. Department of Cardiology, The University of Texas M.D. Anderson Cancer Center, Houston, TX, 77030, USA

    Jean-Bernard Durand

Authors
  1. Alda Tam
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  2. Joe E. Ensor
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  3. Holly Snyder
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  4. Sanjay Gupta
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  5. Jean-Bernard Durand
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  6. Michael J. Wallace
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Correspondence to Alda Tam.

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This work was accepted for oral abstract presentation at RSNA 2008.

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Tam, A., Ensor, J.E., Snyder, H. et al. Image-Guided Drainage of Pericardial Effusions in Oncology Patients. Cardiovasc Intervent Radiol 32, 1217–1226 (2009). https://doi.org/10.1007/s00270-009-9594-7

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  • DOI: https://doi.org/10.1007/s00270-009-9594-7

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