Risk factors concerning sternal bone marrow aspiration and patient safety in Japan.
OBJECTIVE
Several reports have described adverse events resulting from sternal bone marrow aspiration procedures. We hypothesized about inevitable lacerations to the ascending aorta that occur from structural abnormalities in the needle passage.


METHODS
We evaluated dimensions in the thorax related to the sternal bone marrow aspiration, using a chest CT scan on a display terminal. Patients Among the 3,848 patients who visited our institution and underwent a chest CT scan between September 1, 2007 and December 31, 2008, a total of 153 subjects showing no particular chest CT findings were enrolled.


RESULTS
Significant variation was observed in the distance from the sternum to the ascending aorta, from a minimum of 4.2 to a maximum of 47.6 mm (median 23.6) in men and a minimum of 5.2 to a maximum of 38.4 mm (median 21.3) in women. There were three men (3.6%) and women (4.3%) each having a distance within 10 mm.


CONCLUSIONS
Our findings showed for the first time that an anterior chest approach to sternal bone marrow aspiration involves an inevitable risk of laceration of the ascending aorta, when the needle tip penetrates the sternum. Our analysis of dimension also suggested that the sternal marrow aspiration procedure involved a greater risk among older subjects of short stature.
Inoue
Hiroshi
H
Division of Pulmonary Medicine, Allergy, and Rheumatology, Department of Internal Medicine, Iwate Medical University School of Medicine, Iwate, Japan. hiroshi.inoue@r2.dion.ne.jp
Nakasato
Tatsuhiko
T
Yamauchi
Kohei
K
Nakamura
Yutaka
Y
Oshida
Shigemi
S
Ehara
Shigeru
S
D000328:Adult; D000368:Aged; D001011:Aorta / Q000033:anatomy & histology* / Q000473:pathology; D001027:Aortography / Q000009:adverse effects; D044963:Biopsy, Fine-Needle / Q000009:adverse effects*; D001827:Body Height; D001853:Bone Marrow / Q000000981:diagnostic imaging*; D005260:Female; D006801:Humans; D007564:Japan; D022125:Lacerations / Q000209:etiology / Q000517:prevention & control; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D017751:Safety Management; D013249:Sternum / Q000000981:diagnostic imaging*; D014057:Tomography, X-Ray Computed; D055815:Young Adult