Efficacy of a Self-expanding Tract Sealant Device in the Reduction of Pneumothorax and Chest Tube Placement Rates After Percutaneous Lung Biopsy: A Matched Controlled Study Using Propensity Score Analysis.
OBJECTIVE
To evaluate the use of a self-expanding tract sealant device (BioSentry™) on the rates of pneumothorax and chest tube insertion after percutaneous lung biopsy.


METHODS
In this retrospective study, we compared 318 patients who received BioSentry™ during percutaneous lung biopsy (treated group) with 1956 patients who did not (control group). Patient-, lesion-, and procedure-specific variables, and pneumothorax and chest tube insertion rates were recorded. To adjust for potential selection bias, patients in the treated group were matched 1:1 to patients in the control group using propensity score matching based on the above-mentioned variables. Patients were considered a match if the absolute difference in their propensity scores was ≤equal to 0.02.


RESULTS
Before matching, the pneumothorax and chest tube rates were 24.5 and 13.1% in the control group, and 21.1 and 8.5% in the treated group, respectively. Using propensity scores, a match was found for 317 patients in the treatment group. Chi-square contingency matched pair analysis showed the treated group had significantly lower pneumothorax (20.8 vs. 32.8%; p = 0.001) and chest tube (8.2 vs. 20.8%; p < 0.0001) rates compared to the control group. Sub-analysis including only faculty who had >30 cases of both treatment and control cases demonstrated similar findings: the treated group had significantly lower pneumothorax (17.6 vs. 30.2%; p = 0.002) and chest tube (7.2 vs. 18%; p = 0.001) rates.


CONCLUSIONS
The self-expanding tract sealant device significantly reduced the pneumothorax rate, and more importantly, the chest tube placement rate after percutaneous lung biopsy.
Department of Interventional Radiology, The University of Texas M.D. Anderson Cancer Center, Houston, TX, USA. judy.ahrar@mdanderson.org.|Unit 1471, Department of Interventional Radiology, The University of Texas M.D. Anderson Cancer Center, PO Box 301402, Houston, TX, 77230-1402, USA. judy.ahrar@mdanderson.org.
Judy U
JU
Ahrar
Department of Interventional Radiology, The University of Texas M.D. Anderson Cancer Center, Houston, TX, USA.
Sanjay
S
Gupta
The Houston Methodist Cancer Center, Houston Methodist Research Institute, Houston, TX, USA.
Joe E
JE
Ensor
Department of Interventional Radiology, The University of Texas M.D. Anderson Cancer Center, Houston, TX, USA.
Armeen
A
Mahvash
Department of Interventional Radiology, The University of Texas M.D. Anderson Cancer Center, Houston, TX, USA.
Sharjeel H
SH
Sabir
Department of Interventional Radiology, The University of Texas M.D. Anderson Cancer Center, Houston, TX, USA.
Joseph R
JR
Steele
Department of Interventional Radiology, The University of Texas M.D. Anderson Cancer Center, Houston, TX, USA.
Stephen E
SE
McRae
Department of Interventional Radiology, The University of Texas M.D. Anderson Cancer Center, Houston, TX, USA.
Rony
R
Avritscher
Department of Interventional Radiology, The University of Texas M.D. Anderson Cancer Center, Houston, TX, USA.
Steven Y
SY
Huang
Department of Interventional Radiology, The University of Texas M.D. Anderson Cancer Center, Houston, TX, USA.
Bruno C
BC
Odisio
Department of Interventional Radiology, The University of Texas M.D. Anderson Cancer Center, Houston, TX, USA.
Ravi
R
Murthy
Department of Interventional Radiology, The University of Texas M.D. Anderson Cancer Center, Houston, TX, USA.
Kamran
K
Ahrar
Department of Interventional Radiology, The University of Texas M.D. Anderson Cancer Center, Houston, TX, USA.
Michael J
MJ
Wallace
Department of Interventional Radiology, The University of Texas M.D. Anderson Cancer Center, Houston, TX, USA.
Alda L
AL
Tam
D001707:Biopsy, Needle / Q000009:adverse effects; D015505:Chest Tubes / Q000706:statistics & numerical data*; D004867:Equipment Design; D005260:Female; D006801:Humans; D020100:Hydrogels / Q000008:administration & dosage / Q000627:therapeutic use*; D008168:Lung / Q000000981:diagnostic imaging / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D011030:Pneumothorax / Q000517:prevention & control*; D057216:Propensity Score; D015641:Radiography, Interventional / Q000379:methods; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed / Q000379:methods; D016896:Treatment Outcome
D020100:Hydrogels
Biosentry; Chest tube placement; Lung biopsy; Pneumothorax