CardioVascular and Interventional Radiology

, Volume 38, Issue 4, pp 971–976 | Cite as

Simultaneous Multiple Preoperative Localizations of Small Pulmonary Lesions Using a Short Hook Wire and Suture System

  • Toshihiro IguchiEmail author
  • Takao Hiraki
  • Hideo Gobara
  • Hiroyasu Fujiwara
  • Yusuke Matsui
  • Seiichiro Sugimoto
  • Shinichi Toyooka
  • Takahiro Oto
  • Shinichiro Miyoshi
  • Susumu Kanazawa
Clinical Investigation



The aim of the study was to retrospectively evaluate simultaneous multiple hook wire placement outcomes before video-assisted thoracoscopic surgery (VATS).

Materials and Methods

Thirty-eight procedures were performed on 35 patients (13 men and 22 women; mean age, 59.9 years) with 80 lung lesions (mean diameter 7.9 mm) who underwent simultaneous multiple hook wire placements for preoperative localizations. The primary endpoints were technical success, complications, procedure duration, and VATS outcome; secondary endpoints included comparisons between technical success rates, complication rates, and procedure durations of the 238 single-placement procedures performed. Complications were also evaluated.


In 35 procedures including 74 lesions, multiple hook wire placements were technically successful; in the remaining three procedures, the second target placement was aborted because of massive pneumothorax after the first placement. Although complications occurred in 34 procedures, no grade 3 or above adverse event was observed. The mean procedure duration was 36.4 ± 11.8 min. Three hook wires dislodged during patient transport to the surgical suite. Seventy-four successfully marked lesions were resected. Six lesions without hook wires were successfully resected after detection by palpation with an additional mini-thoracotomy or using subtle pleural changes as a guide. The complication rates and procedure durations of multiple-placement procedures were significantly higher (P = 0.04) and longer (P < 0.001) than those in the single-placement group, respectively, while the technical success rate was not significantly different (P = 0.051).


Simultaneous multiple hook wire placements before VATS were clinically feasible, but increased the complication rate and lengthened the procedure time.


Non-vascular interventions Lung/pulmonary Cancer 


Conflict of interest

Toshihiro Iguchi, Takao Hiraki, Hideo Gobara, Hiroyasu Fujiwara, Yusuke Matsui, Seiichiro Sugimoto, Shinichi Toyooka, Takahiro Oto, Shinichiro Miyoshi, and Susumu Kanazawa have no conflicts of interest to declare.

Informed Consent

Informed consent was obtained from all individual participants included in the study.

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.


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Copyright information

© Springer Science+Business Media New York and the Cardiovascular and Interventional Radiological Society of Europe (CIRSE) 2014

Authors and Affiliations

  • Toshihiro Iguchi
    • 1
    Email author
  • Takao Hiraki
    • 1
  • Hideo Gobara
    • 1
  • Hiroyasu Fujiwara
    • 1
  • Yusuke Matsui
    • 1
  • Seiichiro Sugimoto
    • 2
  • Shinichi Toyooka
    • 2
    • 3
  • Takahiro Oto
    • 2
  • Shinichiro Miyoshi
    • 2
  • Susumu Kanazawa
    • 1
  1. 1.Department of RadiologyOkayama University Medical SchoolOkayamaJapan
  2. 2.Department of General Thoracic SurgeryOkayama University Medical SchoolOkayamaJapan
  3. 3.Department of Clinical Genomic MedicineOkayama University Medical SchoolOkayamaJapan

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