Abstract
Purpose
To evaluate the feasibility and safety of the computed tomography (CT)-guided femoral approach for draining a psoas muscle abscess (PMA).
Materials and Methods
Between January 2014 and November 2018, the CT-guided femoral approach was employed for 9 abscesses in 8 patients who could not tolerate the prone position because of advanced age or other underlying conditions. A 17-gauge blunt metal needle was used to puncture the iliacus muscle below the groin under CT fluoroscopic guidance. A drainage catheter was then placed within the abscess cavity in the psoas major muscle. Technical success, clinical success, complications, the drainage therapy duration, susceptibility to antibiotics, survival, and recurrence were evaluated.
Results
The technical success rate was 100% among all nine lesions. The clinical success rate was 89% among all eight patients. One patient died of concomitant meningitis 15 days after the procedure. No patients developed therapy-related complications. The median duration of the drainage therapy was 15 days (range 6–71 days). Appropriate antibiotics based on the culture susceptibility were achieved in all patients. Four patients survived, and the remaining four died at 15 to 758 days (median, 36 days) after the procedure; no therapy-related deaths occurred. No recurrence was seen.
Conclusion
The CT-guided femoral approach seems feasible, effective, and safe for draining psoas muscle abscesses in ill patients who cannot tolerate the prone position.
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Acknowledgments
We thank Angela Morben, DVM, ELS, from Edanz (https://jp.edanz.com/ac) for editing a draft of this manuscript.
Funding
This study was not supported by any funding.
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Kei Yamada has received a research grant from Doctor-NET Inc., Fukushima SiC Applied Engineering INC., Nihon Medi-Physics Co., Ltd., Guerbet Japan KK, Bracco-Eisai Co., Ltd. Other authors (Natsuko Hayashi, Yoshito Takeuchi, Hiroyuki Morishita, and Naoki Ehara) declare that they have no conflict of interest.
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Hayashi, N., Takeuchi, Y., Morishita, H. et al. CT-Guided Femoral Approach for Psoas Muscle Abscess Drainage. Cardiovasc Intervent Radiol 45, 522–526 (2022). https://doi.org/10.1007/s00270-022-03060-y
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DOI: https://doi.org/10.1007/s00270-022-03060-y