title: Pulmonary Intraparenchymal Blood Patching Decreases the Rate of Pneumothorax-Related Complications following Percutaneous CT-Guided Needle Biopsy.
abstract: OBJECTIVE
  To investigate whether an autologous intraparenchymal blood patch (IPB) reduces the rate of pneumothorax-related complications associated with computed tomography (CT)-guided lung biopsies.
  
  
  METHODS
  This study included 834 patients: 482 who received an IPB and 352 who did not. Retrospective review was performed of all CT-guided lung biopsies performed at a single institution between August 2006 and September 2013. Patients were excluded if no aerated lung was crossed. The rate of pneumothorax, any associated intervention (eg, catheter placement, aspiration), chest tube placement, and chest tube replacement requiring hospital admission were compared by linear and multiple regression analysis.
  
  
  RESULTS
  Patients who received an IPB had a significantly lower rate of pneumothorax (145 of 482 [30%] vs 154 of 352 [44%]; P < .0001), pneumothorax-related intervention (eg, catheter aspiration, pleural blood patch, chest tube placement; 43 of 482 [8.9%] vs 85 of 352 [24.1%]; P < .0001), and chest tube placement along with other determinants requiring hospital admission (18 of 482 [3.7%] vs 27 of 352 [7.7%]; P < .0001). No complications related to the IPB were noted in the study group.
  
  
  CONCLUSIONS
  Autologous IPB placement is associated with a decreased rate of pneumothorax and associated interventions, including chest tube placement and hospital admission, after CT-guided lung biopsies, with no evidence of any adverse effects. These results suggest that an IPB is safe and effective and should be considered when aerated lung is traversed while performing a CT-guided lung biopsy.
authors.affiliation: Department of Radiology, University of Wisconsin School of Medicine and Public Health, 600 Highland Ave., Mail Code 3252, Madison, WI 53792-3252. Electronic address: graffy@wisc.edu.
authors.forename: Peter
authors.initials: P
authors.lastname: Graffy
authors.affiliation: Department of Radiology, University of Wisconsin School of Medicine and Public Health, 600 Highland Ave., Mail Code 3252, Madison, WI 53792-3252.
authors.forename: Scott B
authors.initials: SB
authors.lastname: Loomis
authors.affiliation: Department of Radiology, University of Wisconsin School of Medicine and Public Health, 600 Highland Ave., Mail Code 3252, Madison, WI 53792-3252.
authors.forename: Perry J
authors.initials: PJ
authors.lastname: Pickhardt
authors.affiliation: Department of Radiology, University of Wisconsin School of Medicine and Public Health, 600 Highland Ave., Mail Code 3252, Madison, WI 53792-3252.
authors.forename: Meghan G
authors.initials: MG
authors.lastname: Lubner
authors.affiliation: Department of Radiology, University of Wisconsin School of Medicine and Public Health, 600 Highland Ave., Mail Code 3252, Madison, WI 53792-3252.
authors.forename: Douglas R
authors.initials: DR
authors.lastname: Kitchin
authors.affiliation: Department of Radiology, University of Wisconsin School of Medicine and Public Health, 600 Highland Ave., Mail Code 3252, Madison, WI 53792-3252.
authors.forename: Fred T
authors.initials: FT
authors.lastname: Lee
authors.affiliation: Department of Radiology, University of Wisconsin School of Medicine and Public Health, 600 Highland Ave., Mail Code 3252, Madison, WI 53792-3252.
authors.forename: J Louis
authors.initials: JL
authors.lastname: Hinshaw
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001691:Biological Therapy / Q000009:adverse effects / Q000379:methods*; D001707:Biopsy, Needle / Q000009:adverse effects; D005260:Female; D006801:Humans; D061705:Image-Guided Biopsy / Q000009:adverse effects / Q000379:methods*; D008168:Lung / Q000000981:diagnostic imaging / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D011030:Pneumothorax / Q000175:diagnosis / Q000209:etiology / Q000517:prevention & control*; D012189:Retrospective Studies; D012307:Risk Factors; D014057:Tomography, X-Ray Computed / Q000009:adverse effects*; D016896:Treatment Outcome; D055815:Young Adult