Risk Factors of Pneumothorax and Bleeding*: Multivariate Analysis of 660 CT-Guided Coaxial Cutting Needle Lung Biopsies


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Abstract

Background:The results of studies identifying the risk factors for pneumothorax and bleeding in CT-guided coaxial lung needle biopsies were inconsistent and some were even contradictory. All reported series were small with patient populations averaging about 200.Study objectives:To determine the risk factors for pneumothorax and bleeding after CT-guided coaxial cutting needle biopsy of lung lesions.Design:Retrospective analysis.Methods:We reviewed 660 biopsy procedures. The risk factors for pneumothorax and bleeding were determined by multivariate analysis of variables related to patient demographics, lung lesions, biopsy procedures, and the individual radiologist.Results:The main complications were pneumothorax (23% 155 of 660 procedures), chest tube insertion (1% 9 of 660 procedures), and hemoptysis (4% 26 of 660 procedures), with no patient mortality. The highest pneumothorax rate correlated with a lesion size of ≤ 2 cm, a lesion depth of 0.1 to 2 cm, and less experienced radiologists. The highest bleeding risk correlated with a lesion size ≤ 2 cm, a lesion depth of ≥ 2.1 cm, and the absence of pleural effusion.Conclusions:The risk factors for highest pneumothorax rate are lesion size ≤ 2 cm, a subpleural lesion depth of 0.1 to 2.0 cm, and a less experienced radiologist. The risk factors for highest bleeding rate are lesion size ≤ 2 cm, lesion depth ≥ 2.1 cm, and lung lesions not associated with a pleural effusion.[]

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