title: A novel modified PAIR technique using a trocar catheter for percutaneous treatment of liver hydatid cysts: a six-year experience.
abstract: OBJECTIVE
  We aimed to demonstrate the success and reliability of a novel puncture, aspiration, injection, and reaspiration (PAIR) technique in liver hydatid cysts.
  
  
  METHODS
  Percutaneous treatment with ultrasonographic guidance was performed in 493 hepatic hydatid cysts in 374 patients. Patients were treated with a new PAIR technique by single puncture method using a 6F trocar catheter. The results of this novel technique were evaluated with regards to efficacy and safety of the procedure and complication rates.
  
  
  RESULTS
  Out of 493 cysts, 317 were Gharbi type I (WHO CE 1) and 176 were Gharbi type II (WHO CE 3A). Of all cysts, 13 were referred to surgery because of cystobiliary fistulization. Recurrence was observed in 11 cysts one month later. Therefore, the success rate of the PAIR technique was 97.7% (469/480). Minor complications (fever, urticaria-like reactions, biliary fistula) were seen in 44 treated patients (12%, 44/374); the only major complication was reversible anaphylactic shock which was observed in two patients (0.5%, 2/374).
  
  
  CONCLUSIONS
  This novel modified PAIR technique may be superior to catheterization by Seldinger technique due to its efficiency, easier application, lower severe complication rate, and lower cost. Further comparative studies are required to confirm our observations.
authors.affiliation: Department of Radiology, Selçuk University School of Medicine, Konya, Turkey. naymanalaaddin@hotmail.com.
authors.forename: Alaaddin
authors.initials: A
authors.lastname: Nayman
authors.forename: Ibrahim
authors.initials: I
authors.lastname: Guler
authors.forename: Suat
authors.initials: S
authors.lastname: Keskin
authors.forename: Tuba Berra
authors.initials: TB
authors.lastname: Erdem
authors.forename: Hale
authors.initials: H
authors.lastname: Borazan
authors.forename: Ahmet
authors.initials: A
authors.lastname: Kucukapan
authors.forename: Huseyin
authors.initials: H
authors.lastname: Ozbiner
authors.forename: Abdussamed
authors.initials: A
authors.lastname: Batur
authors.forename: Ersen
authors.initials: E
authors.lastname: Ertekin
authors.forename: Bahadir
authors.initials: B
authors.lastname: Feyzioglu
authors.forename: Osman
authors.initials: O
authors.lastname: Koc
authors.forename: Hasan Emin
authors.initials: HE
authors.lastname: Kaya
authors.forename: Osman
authors.initials: O
authors.lastname: Temizoz
authors.forename: Adil
authors.initials: A
authors.lastname: Kartal
authors.forename: Orhan
authors.initials: O
authors.lastname: Ozbek
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002404:Catheterization / Q000295:instrumentation; D002648:Child; D004444:Echinococcosis, Hepatic / Q000628:therapy*; D005260:Female; D006801:Humans; D007267:Injections; D008297:Male; D008875:Middle Aged; D011677:Punctures / Q000295:instrumentation / Q000379:methods; D015203:Reproducibility of Results; D012189:Retrospective Studies; D013396:Suction / Q000295:instrumentation / Q000379:methods*; D016896:Treatment Outcome; D055815:Young Adult