title: CT fluoroscopy-guided preoperative short hook wire placement for small pulmonary lesions: evaluation of safety and identification of risk factors for pneumothorax.
abstract: OBJECTIVE
  To retrospectively evaluate the safety of computed tomography (CT) fluoroscopy-guided short hook wire placement for video-assisted thoracoscopic surgery and the risk factors for pneumothorax associated with this procedure.
  
  
  METHODS
  We analyzed 267 short hook wire placements for 267 pulmonary lesions (mean diameter, 9.9 mm). Multiple variables related to the patients, lesions, and procedures were assessed to determine the risk factors for pneumothorax.
  
  
  RESULTS
  Complications (219 grade 1 and 4 grade 2 adverse events) occurred in 196 procedures. No grade 3 or above adverse events were observed. Univariate analysis revealed increased vital capacity (odds ratio [OR], 1.518; P = 0.021), lower lobe lesion (OR, 2.343; P =0.001), solid lesion (OR, 1.845; P = 0.014), prone positioning (OR, 1.793; P = 0.021), transfissural approach (OR, 11.941; P = 0.017), and longer procedure time (OR, 1.036; P = 0.038) were significant predictors of pneumothorax. Multivariate analysis revealed only the transfissural approach (OR, 12.171; P = 0.018) and a longer procedure time (OR, 1.048; P = 0.012) as significant independent predictors.
  
  
  CONCLUSIONS
  Complications related to CT fluoroscopy-guided preoperative short hook wire placement often occurred, but all complications were minor. A transfissural approach and longer procedure time were significant independent predictors of pneumothorax.
  
  
  CONCLUSIONS
  Complications related to CT fluoroscopy-guided preoperative short hook wire placement often occur. Complications are usually minor and asymptomatic. A transfissural approach and longer procedure time are significant independent predictors of pneumothorax.
authors.affiliation: Departments of Radiology, Okayama University Medical School, 2-5-1 Shikata-cho kita-ku, Okayama, 700-8558, Japan. iguchi@ba2.so-net.ne.jp.
authors.forename: Toshihiro
authors.initials: T
authors.lastname: Iguchi
authors.affiliation: Departments of Radiology, Okayama University Medical School, 2-5-1 Shikata-cho kita-ku, Okayama, 700-8558, Japan. takaoh@tc4.so-net.ne.jp.
authors.forename: Takao
authors.initials: T
authors.lastname: Hiraki
authors.affiliation: Departments of Radiology, Okayama University Medical School, 2-5-1 Shikata-cho kita-ku, Okayama, 700-8558, Japan. gobara@cc.okayama-u.ac.jp.
authors.forename: Hideo
authors.initials: H
authors.lastname: Gobara
authors.affiliation: Departments of Radiology, Okayama University Medical School, 2-5-1 Shikata-cho kita-ku, Okayama, 700-8558, Japan. hirofujiwar@gmail.com.
authors.forename: Hiroyasu
authors.initials: H
authors.lastname: Fujiwara
authors.affiliation: Departments of Radiology, Okayama University Medical School, 2-5-1 Shikata-cho kita-ku, Okayama, 700-8558, Japan. wckyh140@yahoo.co.jp.
authors.forename: Yusuke
authors.initials: Y
authors.lastname: Matsui
authors.affiliation: General Thoracic Surgery, Okayama University Medical School, 2-5-1 Shikata-cho kita-ku, Okayama, 700-8558, Japan. smiyoshi@md.okayama-u.ac.jp.
authors.forename: Shinichiro
authors.initials: S
authors.lastname: Miyoshi
authors.affiliation: Departments of Radiology, Okayama University Medical School, 2-5-1 Shikata-cho kita-ku, Okayama, 700-8558, Japan. susumu@cc.okayama-u.ac.jp.
authors.forename: Susumu
authors.initials: S
authors.lastname: Kanazawa
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005471:Fluoroscopy / Q000379:methods*; D006801:Humans; D015994:Incidence; D007564:Japan / Q000453:epidemiology; D008171:Lung Diseases / Q000000981:diagnostic imaging / Q000601:surgery*; D008175:Lung Neoplasms / Q000150:complications / Q000000981:diagnostic imaging*; D008297:Male; D008875:Middle Aged; D011030:Pneumothorax / Q000000981:diagnostic imaging* / Q000453:epidemiology / Q000209:etiology; D011300:Preoperative Care / Q000009:adverse effects / Q000379:methods*; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D025321:Surgery, Computer-Assisted / Q000379:methods; D013537:Sutures / Q000009:adverse effects*; D020775:Thoracic Surgery, Video-Assisted; D014057:Tomography, X-Ray Computed / Q000379:methods*; D055815:Young Adult
keywords: Complications; Interventional radiology; Lung; Pneumothorax; Video-assisted thoracoscopic surgery