Specially Designed Double-Loop Versus Single-Loop 10.2-Fr Multihole Pigtail Catheters for Pleural Effusion Drainage: A Retrospective Comparative Study of Procedural Efficiency, Catheter Stability, and Safety.

PURPOSE: To determine whether procedural efficiency, catheter stability, and safety differ between specially designed double-loop (DPC) and single-loop (SPC) 10.2-F multihole pigtail catheters for pleural effusion and to assess the independent association between catheter type and instability.

MATERIALS AND

METHODS

This single-center retrospective study (January 2024 to August 2025) analyzed 577 procedures (DPC, n = 299; SPC, n = 278). Inclusion required 10.2-F multihole catheters under combined ultrasound (US)-fluoroscopic guidance. Minimal effusions or incomplete records were excluded. Sample size included all eligible procedures without an a priori power calculation. Primary outcomes were catheter retraction and dislodgment. Secondary outcomes included procedure/fluoroscopy time, radiation exposure, success rates, and adverse events. Multivariable logistic regression evaluated the association between catheter type and retraction.

RESULTS

DPC showed significantly lower retraction (0.7% [95% confidence interval (CI), 0.1%-2.4%] vs 16.9% [95% CI, 12.7%-21.8%]; P < .001) and dislodgment (0.3% [95% CI, 0.0%-1.8%] vs 2.9% [95% CI, 1.3%-5.6%]; P = .02). On multivariable analysis, DPC was independently associated with lower retraction odds (adjusted odds ratio, 0.034; 95% CI, 0.008-0.141; P < .001). DPC significantly reduced procedure time (11.9 vs 16.3 minutes), fluoroscopy time (20.4 vs 43.7 seconds), and radiation exposure (4.6 vs 10.0 mGy; all P < .001). Technical and clinical success rates were 100% in both groups. Overall adverse event rates were low and similar (2.0% vs 1.8%; P > .05).

CONCLUSIONS

DPC demonstrated lower retraction and dislodgment rates than SPC. Its intrinsic anchoring mechanism not only simplifies the procedure and obviates the need for skin fixation but also reduces overall procedure time and radiation exposure.