title: Percutaneous Pericardial Effusion Drainage under Ultrasonographic and Fluoroscopic Guidance for Symptomatic Pericardial Effusion: A Single-Center Experience in 93 Consecutive Patients.
abstract: OBJECTIVE
  To evaluate the safety and efficacy of ultrasound-guided and fluoroscopically guided percutaneous pericardial effusion drainage as performed by interventional radiologists in patients with symptomatic pericardial effusion.
  
  
  METHODS
  From July 2002 to December 2013, 93 patients were treated with percutaneous pericardial effusion drainage. Pericardial effusion drainage was performed via 3 routes: apical, subxiphoid, and transhepatic routes. After puncturing the pericardial sac with a 22-gauge needle under ultrasound guidance, a drainage catheter was inserted under fluoroscopic guidance. Pericardial effusion was categorized according to its distribution in the pericardial cavity: "circumferential even," "circumferential uneven" (predominant site specified), and "loculated." Technical success, recurrence, and complication rates were assessed.
  
  
  RESULTS
  The technical success rate was 99%. Pericardial effusion drainage was performed via the subxiphoid approach in 54 procedures, transhepatic approach in 30 procedures, and apical approach in 13 procedures. The transhepatic approach was mainly performed in cases where the effusion was distributed posteriorly to the heart (80%). One patient died of uncontrolled hypotension without evidence of hemopericardium.
  
  
  CONCLUSIONS
  Ultrasound-guided and fluoroscopically guided pericardial effusion drainage is a safe and effective procedure for patients with symptomatic pericardial effusion. The transhepatic approach may be preferable for posteriorly distributed pericardial effusion that would otherwise be inaccessible by a traditional subxiphoid or apical approach.
authors: Departments of Radiology, , San 5, Woncheon-dong, Yeongtong-gu, Suwon 443-721, South Korea.
authors: Eun Young
authors: EY
authors: Kim
authors: Departments of Radiology, , San 5, Woncheon-dong, Yeongtong-gu, Suwon 443-721, South Korea. Electronic address: wonkwak@ajou.ac.kr.
authors: Je Hwan
authors: JH
authors: Won
authors: Departments of Radiology, , San 5, Woncheon-dong, Yeongtong-gu, Suwon 443-721, South Korea.
authors: Jinoo
authors: J
authors: Kim
authors: Cardiology, Ajou University School of Medicine, San 5, Woncheon-dong, Yeongtong-gu, Suwon 443-721, South Korea.
authors: Jin Sun
authors: JS
authors: Park
mesh_terms: D005260:Female; D005471:Fluoroscopy / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010490:Pericardial Effusion / Q000175:diagnosis / Q000453:epidemiology* / Q000601:surgery*; D020519:Pericardiocentesis / Q000379:methods / Q000706:statistics & numerical data*; D015995:Prevalence; D015203:Reproducibility of Results; D056910:Republic of Korea; D012189:Retrospective Studies; D012307:Risk Factors; D012680:Sensitivity and Specificity; D025321:Surgery, Computer-Assisted / Q000706:statistics & numerical data*; D016896:Treatment Outcome; D018084:Ultrasonography, Interventional / Q000706:statistics & numerical data*