Efficacy of Tract Embolization on Reducing Pneumothorax in CT-Guided Transthoracic Lung Biopsies: Comparison of Saline and Autologous Blood Patch.

RATIONALE AND

OBJECTIVES

This study aimed to evaluate the effectiveness of two techniques "autologous blood patch (ABP) and saline sealing" in preventing pneumothorax during CT-guided percutaneous transthoracic lung biopsies (PTTLB).

MATERIALS AND

METHODS

We analyzed 218 PTTLB procedures performed on 202 patients, categorizing them into three groups: those receiving ABP, those receiving saline, and a control group with no intervention. We assessed pneumothorax and catheter drainage rates and analyzed potential risk factors, including demographics, procedural positioning, pleura-skin distance, lesion characteristics, and emphysema scores.

RESULTS

The overall pneumothorax rate was 25.9%, with 4.3% requiring chest tube insertion. Pneumothorax rates were significantly lower in the ABP (20.3%) and saline groups (17.6%) compared to the control group (44.2%). Catheter drainage rates were 2.7% for saline, 3.4% for ABP, and 7.7% for the control group, with no significant differences (p>0.05). A needle tract thickness of ≥12 mm following injection was identified as a protective factor against pneumothorax (p=0.003).

CONCLUSION

Both autologous blood patch and saline injections into the needle tract are effective strategies for reducing the incidence of pneumothorax during lung biopsies performed with a coaxial system. We propose that saline can be safely used as an alternative to autologous blood patch due to the latter's disadvantages, including the requirement for blood collection from the patient and pre-procedural preparation, while the saline technique offers the advantage of easier application with similar efficacy.